Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019

Authors

Salik Nazir
Robert W Ariss
Abdul Mannan Khan Minhas
Rochell Issa
Erin D Michos
Yochai Birnbaum
George V Moukarbel
P Kasi Ramanathan
Hani Jneid

Publication Date

4-5-2022

Journal

Journal of the American Heart Association

DOI

10.1161/JAHA.121.024533

PMID

35301872

PMCID

PMC9075427

PubMedCentral® Posted Date

3-18-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Black or African American, Aged, Aged, 80 and over, Aortic Dissection, Black People, Cross-Sectional Studies, Ethnicity, Female, Humans, Male, Mortality, United States, aortic dissection, epidemiology, mortality, Epidemiology, Race and Ethnicity, Mortality/Survival

Abstract

Background Aortic dissection (AoD) is associated with high morbidity and mortality. However, the burden of AoD mortality is not well characterized, and contemporary data and mortality trends in different demographic and geographic subgroups have not been described. Methods and Results Trends in AoD mortality were assessed using a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Crude and age-adjusted mortality rates (AAMR) per 1 million people with associated annual percent changes were determined. Joinpoint regression was used to assess trends in the overall sample and different demographic (sex, race and ethnicity, age) and geographic subgroups. Between 1999 and 2019, a total of 86 855 AoD deaths occurred within the United States. In the overall population, AAMR was 21.1 per 1 million in 1999 and 21.3 in 2019. After an initial decline in mortality, AAMR increased from 2012 to 2019, with an associated annual change of 2.5% (95% CI, 1.8-3.3). Men, older adults (aged ≥85 years), and non-Hispanic Black or African American individuals had higher mortality rates than women, younger individuals, and other racial and ethnic individuals, respectively. Despite lower AAMRs throughout the study period, women experienced greater increases in AAMR from 2012 to 2019 compared with men. Similarly, non-Hispanic Black or African American individuals had a pronounced increase in AAMR from 2012 to 2019. Conclusions Despite an initial decline in AoD mortality, the mortality rate has been increasing from 2012 to 2019, with pronounced increases among women and non-Hispanic Black or African American individuals.

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