Limitations
The limitations of this study are inherent to the nature of the
database. Although administrative databases are a great source of
national data, coding systems are prone to oversimplification of
pathologies, registry errors, and missed entries. For example, a patient
with a chronic type B dissection and degenerative dilation can be coded
as an aortic aneurysm in some institutions and as dissection in others.
Furthermore, more comprehensive data to address race disparities
holistically is not possible with administrative databases such as the
NIS database. Another limitation is that decompensated comorbid
conditions or other important clinical factors present at admission
cannot be differentiated from chronic stable ones, leading to
confounding. Also, despite these data demonstrating the short-term
advantages of an endovascular approach regardless of race, the
longer-term effects are uncertain. Significant racial/ethnic disparities
might be essential in explaining clinical outcomes concerning
antihypertensive therapy variability, treatment adherence, and
surveillance programs.