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

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...

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Main 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
Format: Article
Language:English
Published: Wiley 2022-04-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.121.024533
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author Salik Nazir
Robert W. Ariss
Abdul Mannan Khan Minhas
Rochell Issa
Erin D. Michos
Yochai Birnbaum
George V. Moukarbel
P. Kasi Ramanathan
Hani Jneid
author_facet Salik Nazir
Robert W. Ariss
Abdul Mannan Khan Minhas
Rochell Issa
Erin D. Michos
Yochai Birnbaum
George V. Moukarbel
P. Kasi Ramanathan
Hani Jneid
author_sort Salik Nazir
collection DOAJ
description 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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spelling doaj.art-eb4fd2f7ef284d0eacff40ba7aef26c62023-04-10T11:57:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-04-0111710.1161/JAHA.121.024533Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019Salik Nazir0Robert W. Ariss1Abdul Mannan Khan Minhas2Rochell Issa3Erin D. Michos4Yochai Birnbaum5George V. Moukarbel6P. Kasi Ramanathan7Hani Jneid8Division of Cardiovascular Medicine University of Toledo Medical Center Toledo OHDivision of Cardiovascular Medicine University of Toledo Medical Center Toledo OHDivision of Medicine Forrest General Hospital Hattiesburg MSDivision of Cardiovascular Medicine University of Toledo Medical Center Toledo OHDivision of Cardiology Johns Hopkins University School of Medicine Baltimore MDSection of Cardiology Baylor College of Medicine Houston TXDivision of Cardiovascular Medicine University of Toledo Medical Center Toledo OHSection of Cardiology ProMedica Toledo Hospital Toledo OHSection of Cardiology Baylor College of Medicine Houston TXBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.121.024533aortic dissectionepidemiologymortality
spellingShingle Salik Nazir
Robert W. Ariss
Abdul Mannan Khan Minhas
Rochell Issa
Erin D. Michos
Yochai Birnbaum
George V. Moukarbel
P. Kasi Ramanathan
Hani Jneid
Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
aortic dissection
epidemiology
mortality
title Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
title_full Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
title_fullStr Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
title_full_unstemmed Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
title_short Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
title_sort demographic and regional trends of mortality in patients with aortic dissection in the united states 1999 to 2019
topic aortic dissection
epidemiology
mortality
url https://www.ahajournals.org/doi/10.1161/JAHA.121.024533
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