Ethnic Disparities in CT Aortography Use for Diagnosing Acute Aortic Syndrome.

Acute Aortic Syndrome Aortic Dissection Aortic Dissection Detection Risk Score CT Angiography Ethnicity Māori Pacific Islander

Journal

Radiology. Cardiothoracic imaging
ISSN: 2638-6135
Titre abrégé: Radiol Cardiothorac Imaging
Pays: United States
ID NLM: 101748663

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 02 02 2022
revised: 31 08 2022
accepted: 13 10 2022
entrez: 5 1 2023
pubmed: 6 1 2023
medline: 6 1 2023
Statut: epublish

Résumé

To determine whether CT aortography was performed in proportion to patient risk for acute aortic syndrome (AAS) and incidence of AAS for different ethnic groups. All atraumatic thoracic aorta CT aortographic examinations performed in adults (age > 15 years) suspected of having AAS between January 2009 and December 2019 at Auckland City Hospital (New Zealand) were included. Patients were risk stratified using the aortic dissection detection risk score (ADD-RS). The primary outcomes were the ratio of CT aortography rates to rates of positive CT aortographic examinations and the incidence of AAS. Population census data were used to determine age-standardized incidence of AAS in the emergency department (ED). In total, 1646 CT aortographic examinations were performed in 1543 patients (mean age, 62 years ± 16 [SD]; 877 male patients). Māori (34% [68 of 203]) and Pacific Islanders (35% [80 of 229]) were more likely to be at high risk of AAS (ADD-RS > 1) compared with patients from other ethnic groups (25% [308 of 1214]); in the ED catchment population, age-standardized AAS incidence was significantly higher in Māori (6.9 per 100 000 person-years [95% CI: 4.3, 10.4]) and Pacific Islanders (5.3 [95% CI: 3.4, 7.8]) than in other ethnic groups (2.3 [95% CI: 1.8, 2.8]). Despite this higher incidence, disproportionately fewer CT aortographic examinations were requested in the ED for Māori (9.2 CT aortographic examinations per AAS diagnosis) and Pacific Islanders (9.2 CT aortographic examinations per AAS diagnosis) compared with other ethnic groups (13.8 CT aortographic examinations per AAS diagnosis). Māori and Pacific Islanders were at disproportionately higher risk of AAS but had fewer requested CT aortographic examinations compared with other ethnic groups. This increased risk of AAS in Pacific Islander and indigenous Māori patients should be considered by clinicians when investigating AAS.

Identifiants

DOI: 10.1148/ryct.220018 PMID: 36601460 PMC: PMC9806728
pubmed: 36601460
doi: 10.1148/ryct.220018
pmc: PMC9806728
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e220018

Informations de copyright

© 2022 by the Radiological Society of North America, Inc.

Déclaration de conflit d'intérêts

Disclosures of conflicts of interest: S. Bhat Block educational grant from Greenlane Research and Education Fund and the National Heart Foundation of NZ (Ellerslie, Auckland, New Zealand). S. Bir No relevant relationships. F.S. No relevant relationships. C.J.B. No relevant relationships. P.G.J. No relevant relationships. S.W.F.R.W. No relevant relationships.

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Auteurs

Sameer Bhat (S)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.
ORCID: 0000-0003-3770-8996

Shreya Bir (S)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.

Franco Schreve (F)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.

Colleen J Bergin (CJ)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.
ORCID: 0000-0002-6919-3440

Peter G Jones (PG)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.
ORCID: 0000-0003-1560-1186

Steve W F R Waqanivavalagi (SWFR)

Departments of Surgery (S. Bhat, P.G.J.) and Medicine (S.W.F.R.W.), The University of Auckland, Auckland, New Zealand; Department of Surgery, University of Otago, Dunedin, New Zealand (S. Bir); and Adult Emergency Department (F.S., P.G.J., S.W.F.R.W.), Department of Radiology (C.J.B.), and Green Lane Cardiothoracic Surgical Unit (S.W.F.R.W.), Auckland City Hospital, Auckland District Health Board, 85 Park Rd, Grafton, Auckland 1142, New Zealand.
ORCID: 0000-0002-0360-9423

Classifications MeSH