P009. A Decade of Insight: Exploring Acute Type A Aortic Dissection Incidence, Outcomes, and Socio-Economic Correlations in a Single-Center Population Study
Royal Papworth Hospital
CAMBRIDGE
United Kingdom - Contact Me
Anchal Jain is a driven core surgical trainee (CT2) at Royal Papworth Hospital, specializing in cardiothoracic surgery. Hailing from India, her journey in medicine led her to the Republic of Ireland, where she pursued her undergraduate studies in medicine at Trinity College Dublin, graduating with honors. Eager to delve deeper into her passion for cardiothoracic surgery, she transitioned to the UK for her specialty training.
Anchal's enthusiasm for the field of cardiothoracic surgery is palpable as she actively seeks out diverse educational opportunities. She serves as a faculty member for the CALS course and has earned her numerous accolades, including the prestigious SCTS Ionescu travel fellowship.
Outside medicine, she has been recognized as an international student ambassador for Ireland's higher education and received the young achiever's award for establishing her own homemade chocolate business, showcasing her entrepreneurial spirit.
As her journey unfolds, Anchal remains steadfast in her dedication to the intricacies of cardiothoracic surgery, driven by a relentless pursuit of knowledge and a desire to make impactful contributions to the medical field.
Description
Given limited epidemiological data on Acute Type A aortic dissection (ATAAD), the objective was to ascertain if there existed any correlation between the occurrence of ATAAD and indices of multiple deprivation (IMD), a comprehensive measure of the socio-economic landscape of a given area.
Methods:
Ten year data (2010-2020) from a single-center encompassing emergency or urgent surgeries for ATAAD and their corresponding postcodes were gathered. IMDs were derived from statistical data procured from the Office for National Statistics. IMD for population range from 1(most deprived 10%) to 10(least deprived 10%). Our analysis encompassed calculating the center's incidence of ATAAD, exploring demographic variables such as age and gender, identifying prevalent risk factors, and assessing survival rates in relation to IMD. Data analysis was performed using Python version 3.10.12.
Results:
A total of 279 patients were included. The calculated incidence of ATAAD stood at 5.5 per 100000 inhabitants, notably higher in IMD 3 and lower in IMD 8. The mean age (standard deviation) of the population affected was 63.28 (13.79) years, with median age of patients surpassing that of the general population per IMD. Predominant risk factors comprised age (p= <0.005), male gender 67.4% (188/279)(p= 0.92) and hypertension(p= 0.66). IMD 3 exhibited the highest 30-day and 5-year mortality rates. Survival rates beyond 30 days post-operation were superior in the least deprived population subset.
Conclusions:
ATAAD stands as a critical and life-threatening cardiovascular emergency mandating urgent surgical intervention. IMD serve as vital socio-economic indicators, offering insights into the relative deprivation experienced by different regions or populations within a country. The observed burden of ATAAD cases at our center, coupled with the scarcity of extensive epidemiological data, prompted this exploration into the potential correlation between ATAAD incidence and socio-economic deprivation as indicated by IMD. These findings shed light on the intricate interplay between socio-economic factors and the incidence and outcomes of ATAAD, potentially informing future research directions and targeted interventions for at-risk populations.
Authors
ANCHAL JAIN (1), Rushmi Purmessur (1), RAVI DE SILVA (1)
Institutions
(1) Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom