Tracking the Decline: Mortality Trends of Thoracic Aortic Aneurysms in the USA from 1999 to 2020

Abstract

Objectives: Aneurysmal degeneration that occurs in the thoracic aorta termed as thoracic aortic aneurysm (TAA), is contributing significantly to global burden of mortality. Despite advancements in medical care, disparities in thoracic aortic aneurysm (TAA) mortality persist across various demographic and regional groups in the United States. This study aims to analyze mortality trends and disparities related to thoracic aortic aneurysm (TAA) in the U.S. adults from 1999 to 2020. Methodology: We analyzed death certificate data from the CDC WONDER database, spanning from 1999 to 2020, focusing on individuals aged 25 years and older. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC), along with 95% confidence intervals (CI), were calculated using Joinpoint regression analysis. Results: Between 1999 and 2020, there were 47,136 TAA related deaths in the U.S, with an overall AAMR of 1.01 per 100,000 individuals. AAMR trends showed an initial sharp decline from 1999 to 2012 (APC: -5.31*) and a stability from 2012 to 2020 (APC: -0.15). Disparities were observed across sex, race/ethnicity, and census regions, with males, NH Blacks, and individuals in Midwest showing higher AAMRs. Rural areas exhibited slightly higher AAMRs than urban areas, although both showed a decline overtime. Conclusion: This study emphasizes the ongoing mortality burden of thoracic aortic aneurysms (TAA) in the United States, revealing notable disparities across different demographic groups and regions. The results highlight the critical need for targeted public health interventions to address these disparities and improve TAA outcomes for all population segments.