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

Abstract

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.