Goyal Aman, Saeed Humza, Shamim Urooj, Siddiqui Momina R, Arshad Muhammad K, Jain Hritvik, Daoud Mohamed, Khan Rozi, Bansal Kamna
Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India.
Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan.
Int J Surg. 2024 Dec 1;110(12):7647-7655. doi: 10.1097/JS9.0000000000002150.
Thoracic aortic aneurysms (TAA) are a significant health concern, with the true prevalence likely underestimated due to undiagnosed cases. Outcomes in TAA are influenced by factors like age, sex, and comorbidities such as hypertension. This study examines mortality trends and disparities associated with TAA in US adults.
This study analyzed death certificates from 1999 to 2020 using the CDC WONDER Database to identify TAA-related deaths in individuals aged 25 and older using ICD-10 codes I71.1 and I71.2. Age-adjusted mortality rates (AAMRs) per 1 000 000 and annual percent changes (APCs) were calculated and stratified by year, sex, age group, race/ethnicity, region, and urbanization status.
Between 1999 and 2020, 47 136 TAA-related deaths were reported among US adults. The AAMR decreased from 16.2 to 8.2 per 1 000 000, with a significant decline from 1999 to 2013 (APC: -5.00; 95% CI: -5.54 to -4.54; P<0.001). Older adults had the highest AAMRs at 44.6 per 1 000 000. Men had higher AAMRs than women (11.2 vs. 9). AAMRs were highest among non-Hispanic (NH) Black (11), followed by NH White (10.3), NH Asian or Pacific Islander (9.5), NH American Indian or Alaska Native (7.8), and Hispanic (5.2) populations. Nonmetropolitan areas had higher AAMRs than metropolitan areas (11 vs. 9.8).
The analysis showed a significant decline in TAA mortality since 1999, with recent stabilization. However, disparities persist, with higher AAMRs among men, older adults, NH Black adults, and nonmetropolitan residents, highlighting the need for targeted and equitable interventions.
胸主动脉瘤（TAA）是一个重大的健康问题，由于存在未被诊断的病例，其实际患病率可能被低估。TAA的预后受到年龄、性别以及高血压等合并症等因素的影响。本研究调查了美国成年人中与TAA相关的死亡率趋势和差异。
本研究使用美国疾病控制与预防中心（CDC）的WONDER数据库分析了1999年至2020年的死亡证明，以使用国际疾病分类第十版（ICD-10）编码I71.1和I71.2识别25岁及以上个体中与TAA相关的死亡。计算了每100万人的年龄调整死亡率（AAMR）和年度百分比变化（APC），并按年份、性别、年龄组、种族/族裔、地区和城市化状况进行分层。
1999年至2020年期间，美国成年人中有47136例与TAA相关的死亡报告。AAMR从每100万人16.2例降至8.2例，1999年至2013年有显著下降（APC：-5.00；95%置信区间：-5.54至-4.54；P<0.001）。老年人的AAMR最高，为每100万人44.6例。男性的AAMR高于女性（11.2对9）。非西班牙裔（NH）黑人中的AAMR最高（11），其次是NH白人（10.3）、NH亚裔或太平洋岛民（9.5）、NH美洲印第安人或阿拉斯加原住民（7.8）以及西班牙裔（5.2）人群。非都市地区的AAMR高于都市地区（11对9.8）。
分析显示自1999年以来TAA死亡率显著下降，近期趋于稳定。然而，差异仍然存在，男性、老年人、NH黑人成年人和非都市居民中的AAMR较高，这突出表明需要有针对性的公平干预措施。
