Trends and Demographics of Vascular Intestinal Diseases-Related Mortality Among Adults Living in United States From 1999 to 2020; A CDC Wonder Analysis

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-09-12 DOI:10.1002/jgh3.70267

Muhammad Shahzad, Kanz Ul Eman Maryam, Ali Hashim, Amna Zaman Khan, Muhammad Abdullah Ali, Ahmed Yar Khan, Muhammad Younas, Syeda Sundus Shah Bokhari, Wania Khalid, Farah Shahzad, Kashmala Zia, Ali Hassan, Muhammad Uzair Khan Niazi, Fahad Rahman, Saad Ahmed Waqas, Raheel Ahmed

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Abstract

Introduction

Vascular intestinal disorders (VID), including mesenteric ischemia, ischemic colitis, and intestinal angiodysplasia, have a global incidence of 8.11/100 000/year and a mortality of 1.26/100 000/year (15.5% death rate), rising from ~1% to ~3% in childhood to ~50% after 95 years. In the US, the incidence of acute vascular insufficiency of the intestine (AVII) is rising, warranting detailed trend analysis.

Methods

CDC WONDER death certificates (1999–2020) for adults > 25 years were analyzed using ICD-10 code N55. Age-adjusted mortality rates (AAMRs) per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.2.0) calculated annual percent changes (APCs); significance was defined as p < 0.05.

Results

Overall AAMR declined from 9.35 (1999) to 5.81 (2020). Women had higher AAMRs (7.63; 95% CI: 7.6–7.66) than men (6.5; 95% CI: 6.49–6.56). By race/ethnicity, AAMRs were highest in NH American Indian (7.89; 95% CI: 7.57–8.21), NH Black (7.84; 95% CI: 7.75–7.9), NH White (7.25; 95% CI: 7.22–7.28), Hispanic (5.91; 95% CI: 5.83–6), and NH Asian (3.59; 95% CI: 3.5–3.68). Micropolitan areas had higher AAMRs (7.92) than metropolitan (6.99). Regional AAMRs were highest in the Midwest (7.7; 95% CI: 7.65–7.75), followed by South (7.17; 95% CI: 7.13–7.21), West (7.02; 95% CI: 6.96–7.07), and Northeast (6.85; 95% CI: 6.79–6.9). Kentucky had the highest state AAMR (9.67; 95% CI: 9.43–9.9), Hawaii the lowest (4.59; 95% CI: 4.31–4.87). Oklahoma, Rhode Island, Tennessee, West Virginia, and Wyoming ranked in the top 90th percentile.

Conclusion

Despite an overall decline, VID mortality remains high among women, NH American Indians, rural areas, and the Midwest—underscoring the need for targeted interventions.

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1999 - 2020年美国成人血管性肠道疾病相关死亡率趋势和人口统计学疾控中心的奇迹分析

血管性肠疾病（VID）包括肠系膜缺血、缺血性结肠炎和肠血管发育不良，全球发病率为8.11/10万/年，死亡率为1.26/10万/年（死亡率15.5%），儿童期为~1% ~ ~3%，95岁后为~50%。在美国，急性肠血管功能不全（AVII）的发病率正在上升，需要详细的趋势分析。方法使用ICD-10代码N55对1999-2020年25岁成人的CDC WONDER死亡证明进行分析。每10万人的年龄调整死亡率（AAMRs）按年份、性别、种族/民族和地区分层。Joinpoint Regression （v5.2.0）计算年度百分比变化（APCs）；显著性定义为p <； 0.05。结果总体AAMR由1999年的9.35降至2020年的5.81。女性的aamr （7.63; 95% CI: 7.6-7.66）高于男性（6.5;95% CI: 6.49-6.56）。按种族/民族划分，aamr在NH美洲印第安人（7.89;95% CI: 7.57-8.21）、NH黑人（7.84;95% CI: 7.75-7.9）、NH白人（7.25;95% CI: 7.22-7.28）、西班牙裔（5.91;95% CI: 5.83-6）和NH亚洲人（3.59;95% CI: 3.5-3.68）中最高。小城市地区的aamr（7.92）高于大城市（6.99）。区域aamr在中西部最高（7.7;95% CI: 7.65-7.75），其次是南部（7.17;95% CI: 7.13-7.21），西部（7.02;95% CI: 6.96-7.07）和东北部（6.85;95% CI: 6.79-6.9）。肯塔基州的AAMR最高（9.67;95% CI: 9.43-9.9），夏威夷最低（4.59;95% CI: 4.31-4.87）。俄克拉何马州、罗德岛州、田纳西州、西弗吉尼亚州和怀俄明州排在前90位。结论：尽管总体下降，妇女、NH美洲印第安人、农村地区和中西部的VID死亡率仍然很高，这强调了有针对性干预的必要性。

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