OBJECTIVES: Marfan syndrome is a rare systemic connective tissue disorder caused by mutations in the gene encoding fibrillin-1 (FBN1). Marfan Syndrome has an estimated prevalence of 1 in 5,000-10,000. Disease manifestations include, but are not limited to, cardiovascular (CV) and pulmonary disorders. Among Marfan patients > 26 years we compared health outcomes, costs and clinical factors. Comparisons were made between CV and pulmonary-related hospital discharges and those not primarily associated with CV or pulmonary manifestations. METHODS: We used data from the 2012 Nationwide Inpatient Sample (NIS) to complete the study. Marfan Syndrome patients >26 years were identified using ICD-9 code 759.82. Patients were stratified by primary diagnosis; CV (CCS:096,097,100,101,103-113,115-118) or pulmonary-related (CCS:128-131,133,134) conditions. Descriptive and inferential statistics were used to compare demographics [race, Charlson Comorbidity Index (CCI), region, and payer information] and healthcare outcomes and charges [length of stay (LOS), mortality, and total charges]. Chi-square and t-tests were used for statistical analysis. The reference group for all analyses included hospital discharges that were not CV or pulmonary-related. RESULTS: