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The main outcome measure was inpatient mortality. The secondary outcomes included hospital length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, adjusted hospital charges (adjusted for geographic region using the Centers for Medicare and Medicaid Services wage index), and frequency of associated diagnostic studies. ICD-9 codes for each admission were the basis of inclusion criteria and variable definitions for this study. Inclusion into the study required the diagnosis of AD (ICD-9 code 441.0x). ICD-9 codes used to define risk factors are listed in Appendix. Patient demographics, ICU data, LOS data, charge data, and mortality were obtained directly from existing PHIS data Selleckchem Pazopanib elements. Classification by risk factor was mutually exclusive. Two patients received ICD-9 codes consistent with CTD and CHD and were ultimately placed in the CTD group. One of these patients had Marfan syndrome and a patent ductus arteriosus while the second patient had Marfan syndrome and congenital mitral valve insufficiency. Patients classified in the HTN group Fluvoxamine had no other discernible risk factor other than HTN. If no risk factor was identifiable by ICD-9 code, the patient was classified into the unspecified group. Patients with the ICD-9 code 746.4, which is the code for bicuspid aortic valve (BAV) and for congenital aortic insufficiency, were included in the CHD category. For the purpose of this paper, this code was used to represent BAV, as has been done in prior large database studies.[13, 14] Given that the data were not normally distributed, descriptive statistics were reported using median and interquartile range (IQR) for continuous variables and proportions for categorical variables. Univariable analysis of categorical variables and mortality was performed using Pearson's chi-square or Fisher's exact test, as appropriate. Continuous variables were analyzed using Mann�CWhitney U-test or Kruskal�CWallis test, as appropriate. Two-tailed test of significance was used in all statistical analyses with statistical significance defined as P IBET762 19 (IBM Corporation, Armonk, NY, USA). A total of 110 patients underwent 124 hospitalizations associated with AD during the study period. During the same period, the entire PHIS database contained a total of 2?943?934 patients and 3?800?964 hospitalizations, yielding an incidence of AD equal to 3 in 100?000 hospitalizations. The median age at time of hospitalization was 12.9 (IQR 3.9�C16.8) years with a bimodal distribution between patients 0�C5 years (27%) and 15�C20 years (43%) (Figure?1). Males were more likely to be affected (69%, P = .003). Associated diagnoses with AD were identified in 95 (86.4%) patients and included CHD in 42 (38.2%), trauma in 26 (23.6%), CTD in 18 (16.4%), and isolated HTN in 9 (8.2%). Excluding the nine patients with isolated HTN, 26 (23.