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Zorggebruik Zorguitkomsten en mortaliteit (Wetenschappelijk) artikel

Exploring ethnic differences in the perioperative course of thoracic aortopathy

Abstract

Background: In patients with thoracic aortopathy post-operative recovery can be complicated by a lack of consistent, clear communication and guidance. Despite the growing recognition of these challenges, the specific needs of patients undergoing aortic surgery, especially across different ethnic groups, remain insufficiently explored. This study aims to examine the peri-operative course in thoracic aortopathy in order to identify the specific needs of the patients, particularly across ethnic groups.

Methods: This cross-sectional, retrospective study included patients who underwent aortic surgery between 2000 and 2023. Patients were asked to complete questionnaires assessing various parts of the pre-, peri-, and (long term) post-operative course. Results were compared between ethnic majority and ethnic minority patients, with further sub-categorization based on the type of aortopathy (aortic dissection vs. thoracic aortic aneurysm). Binary regression models were used, adjusted for age, sex, and follow-up duration when comparing aortopathy types, and additionally for aortic dissection diagnosis when comparing ethnic groups.

Results: A total of 189 patients (174 ethnic majority, 15 minorities) were included. Of these, 115 had type A aortic dissection and 74 had a thoracic aortic aneurysm. Ethnic minority patients showed higher rates of post-operative anxiety (20.0% vs. 5.4%). Minority patients also reported less clarity in post-operative information (p = 0.035). Acute aortic dissection patients reported lower clarity of pre-operative information (7.0 vs. 9.0, p = 0.003) and worse understanding of recovery expectations before surgery (p < 0.001).

Conclusion: This study highlights the critical importance of preand post-operative education in thoracic aortopathy patients. Ethnic disparities in recovery experiences exist, particularly in the domains of post-operative anxiety and communication. Our findings highlight the need for tailored post-operative guidance in order to improve recovery outcomes, and ensure more equitable care.

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