Ethnic Disparities in Thoracic Aortic Dissection and Rupture: A Retrospective Analysis of Hispanic and Non-Hispanic White Populations

Author

• Manuel Gutierrez

Date of Award

Fall 9-19-2025

Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

John A. Elefteriades, M.D, Ph.D

Abstract

Background: Aortic dissections and ruptures are even more strongly life-threatening events for patients who are unable to access care promptly. A dissection can reach 50% mortality rate within 24 hours, and a rupture may exceed 90%. Risk factors such as hypertension, genetics, and age play a role in the development of these events; however, few studies have explored whether marginalized groups, such as Hispanics, experience aortic events more frequently. The primary objective of this investigation is to determine whether there is a difference in the frequency of thoracic aortic dissections or ruptures driven by ethnicity in patients from the Yale New Haven Health System.

Methods: This retrospective cohort study identified 51,859 patients with aortic pathology. Simple chi-square and t-test analyses were performed to compare the frequency of aortic events and various baseline health characteristics between Hispanic and Non-Hispanic White patients. Univariable and multivariable logistic regressions assessed associations between ethnicity and dissection or rupture, while propensity score matching enhanced comparability and confirmed these relationships.

Results: A total of 2,474 patients classified as Hispanic and 34,111 as Non-Hispanic White were identified with thoracic aortic pathology. Dissection or rupture were more frequent in the Hispanic group (7.48% vs 6.13%; P = 0.008). After applying propensity score matching and multivariable logistic regression analysis, Hispanic ethnicity was not statistically significantly associated with dissection or rupture. Significant comorbidities included hypertension (OR = 1.439; P = 0.011), coronary artery disease (OR = 1.286; P = 0.009), atrial fibrillation (OR = 1.240; P = 0.026), and AKI (OR = 2.178; P < 0.001).

Conclusion: After controlling clinical and demographic factors, the observed ethnic disparities in aortic adverse events are likely attributable to underlying differences in baseline health conditions rather than ethnicity itself.

KEYWORDS: thoracic aortic aneurysm, thoracic aortic dissection, thoracic aortic rupture, ethnicity.

Comments

This is an open access thesis.

Recommended Citation

Gutierrez, Manuel, "Ethnic Disparities in Thoracic Aortic Dissection and Rupture: A Retrospective Analysis of Hispanic and Non-Hispanic White Populations" (2025). Yale School of Medicine Physician Associate Program Theses. 233.
https://elischolar.library.yale.edu/ysmpa_theses/233