Black patients wait more than twice as long as White patients for rAAA repair, VQI analysis finds

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Ben Li

Black patients saw significantly delayed care for ruptured abdominal aortic aneurysms (rAAAs), with a Vascular Quality Initiative (VQI) analysis showing a median time from hospital admission to intervention of 168 vs. 78 minutes compared to White patients. 

The finding is part of data on the impact of race on outcomes following rAAA repair presented by Ben Li, MD, a vascular surgery resident at the University of Toronto in Toronto, Ontario, and colleagues at the annual meeting of the Canadian Society for Vascular Surgery (CSVS) in Vancouver, British Columbia (Sept. 9–10). 

Li and colleagues plumbed the VQI database for all Black and White patients who underwent endovascular or open rAAA repair between 2003 and 2019. 

The study’s primary outcomes were in-hospital and eight-year mortality. Some 310 Black and 4,679 White patients were included. 

Li et al found that a greater proportion of Black patients received endovascular repair (73.2% vs. 56.1%), were younger and more likely to be female, and that a greater proportion were uninsured (4.8% vs. 3.3%). 

“Although Black patients were more likely to have cardiovascular comorbidities, they were not more likely to receive risk reduction medications,” Li reported. 

After adjusting for differences in demographic, clinical, and procedural characteristics, in-hospital mortality was similar for Black and White patients, they revealed. There was no difference in eight-year survival between Black and White patients, “which persisted when stratified by endovascular and open repair,” the investigators added. 

“There are important racial differences in demographic, clinical, and procedural characteristics for patients undergoing rAAA repair,” Li and colleagues concluded. 

“In particular, the door-to-intervention time for Black patients of 168 minutes does not meet the Society for Vascular Surgery [SVS] recommendation of 90 minutes. 

“Despite these differences, eight-year mortality is similar for Black and White patients. Future studies should assess reasons for these disparities and [what] opportunities exist to improve rAAA care for Black patients.”

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