Disparities in Aortic Aneurysm Mortality Trends: Revealing Sex and Racial Inequalities

医学 腹主动脉瘤 死亡率 动脉瘤 人口学 人口 主动脉瘤 主动脉夹层 优势比 动脉瘤 内科学 外科 主动脉 环境卫生 社会学
作者
Masashi Azuma,A. P. Ramirez,G. Möser,Kenny Oh,Mohammed A. Kashem,Yoshiya Toyoda,Suyog A. Mokashi
出处
期刊:Vascular and Endovascular Surgery [SAGE Publishing]
标识
DOI:10.1177/15385744251321621
摘要

Background Abdominal aortic dissection or aneurysm (AAA) is a significant health concern in developed nations often underdiagnosed with poor outcomes. Despite a decline in aortic dissection and aneurysm mortality rates in the US from 1999 to 2020, reported by the CDC, this improvement disproportionately favors males and Caucasians. This study aims to elucidate these disparities. Methods Data from the CDC Wonder database from 1999 to 2020 on aortic aneurysm, including abdominal, thoracic, and thoracoabdominal aneurysms and rupture related deaths in the US were analyzed. Mortality rates were compared across sex, race, and geographic location separated by state. Mortality was normalized based on population and analyzed with linear regression models with all plots showing goodness of fit. Results Overall, the mortality gap between male and female cohorts with aortic aneurysm-related deaths widened by 0.57 per 100,000 deaths per year ( P < 0.001). Mortality between Caucasians with African American and Asian American cohorts showed reductions of 0.41 per 100,000 per year ( P < 0.001). Caucasian and male cohorts started at higher mortality rates when compared to their competitive cohorts. Conclusions Despite a reduction in mortality rates among individuals with aortic aneurysm in the US from 1999 to 2020, this decline disproportionately benefits males and Caucasians over African American and Asian populations. Although Caucasians and males had higher mortality in 1999, their decline is significantly greater. Following current trends, Caucasian and male mortalities will be lower than minority groups by 2026. Targeted interventions are needed to address these disparities effectively.
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