Epidemiology, Surgical Management and Mortality of Thoracic Aortic Disease in Australia: A 10-Year Population-Based Study.

Abstract

Aim: Thoracic aortic disease (TAD) is a life-threatening condition with high morbidity and mortality. Australia lacks comprehensive published national data on TAD epidemiology, outcomes, and management. The aim of this study is to estimate the nationwide burden of TAD through hospitalisation, mortality, and surgical interventions.

Methods: A retrospective cohort study analysed hospital admissions for TAD in Australia from 2010 to 2020 using International Classification of Diseases data from the Australian Institute of Health and Welfare. Admissions were stratified by age, sex, and diagnosis, with incidence rates adjusted for population metrics. Surgical data were correlated with thoracic aortic repair codes, and mortality was estimated using hospital and national statistics. The Sydney Local Health District Research Committee granted ethics approval.

Results: Between 2010 and 2020, 16,738 TAD admissions occurred, with 63.3% male. Annual admissions rose significantly from 1,235 to 2,122 (p<0.01). The average incidence was 8.9 per 100,000 males and 5.2 per 100,000 females. Thoracic cases increased by 62% relative to abdominal cases, with a 65% rise in mortality (p<0.01). Males underwent surgery 32% more frequently than females (p<0.001). TAD patients stay in the hospital eight times longer than the population mean. Ten-year mortality was approximately 3,128 deaths, with an annual population TAD mortality rate of 0.015%.

Conclusions: The growing burden of TAD diagnosis in Australia underscores the need for enhanced surveillance and targeted healthcare strategies. Rising admissions, prolonged hospitalisation, and worse female outcomes highlight significant gaps in TAD recognition and management.