Abstract
BACKGROUND: Gastrointestinal complications (GIC) are an uncommon but serious sequelae of type B aortic dissection (TBAD), potentially contributing to increased mortality and healthcare resource utilization. Limited studies have characterized these complications among TBAD patients. The present work sought to evaluate the clinical and financial implications of GIC and identifies factors associated with their development. METHODS: All hospitalizations entailing a primary diagnosis of TBAD were identified in the 2016-2020 Nationwide Readmissions Database. Patients were stratified into those who developed GIC and those who did not. Outcomes included in-hospital mortality, length of stay (LOS), hospitalization costs, and the need for abdominal surgery. Multivariable logistic and linear regressions were employed to assess associations between patient, facility, and treatment factors with clinical and financial outcomes. RESULTS: Of 24,927 TBAD hospitalizations, 2.5 % developed GIC, and 24.0 % of these cases required an abdominal procedure. Patients with GIC were younger (median 61 vs. 67 years; p < 0.001), more commonly male (67.4 vs. 56.6 %; p < 0.001), and more likely to have Medicaid insurance (20.9 vs. 12.5 %; p < 0.001). GIC were independently associated with increased odds of in-hospital mortality (adjusted odds ratio 4.54; 95 % CI 3.41-6.04), greater LOS (β 5.80 days; 95 % CI 3.88-7.72), and increased costs (β $41,000; 95 % CI $31000-51,000). CONCLUSIONS: GIC in TBAD patients was associated with substantial clinical and financial burdens. Further study of early identification and targeted interventions is warranted to mitigate these complications and optimize resource utilization in this high-risk population.