Trends and disparities in aortic dissection mortality in the united states: a retrospective analysis.

BACKGROUND: Aortic Dissection (AD) is a life-threatening condition and one of the major causes of death in the U.S. Despite its clinical significance, trends in AD related mortality remain understudied. We aim to analyze nationwide mortality trends in AD in the U.S. METHODS: Data from CDC WONDER (1999–2024) identified U.S mortality rates in adults aged ≥ 25 years with AD (ICD-10: I71.0). Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). RESULTS: From 1999 to 2024, a total of 115,449 deaths from AD were recorded. The AAMR increased from 2.1 in 1999 to 2.4 in 2024 (AAPC of 0.46; 95% CI: 0.31 to 0.61; p < 0.001). Men had higher mortality than women (Overall AAMR: 2.62; p < 0.001 vs. 1.45; p < 0.001) (AAPC: 0.22; 95% CI: 0.05 to 0.39 vs. 0.61; 95% CI: 0.42 to 0.83) respectively. Racially, non-Hispanic (NH) Blacks demonstrated the greatest overall AAMR of 3.11. Regionally, AAMRs were highest in the Midwest (2.17) followed by the West (2.14). The urban areas had higher overall AAMRs than the rural areas (1.95, p = 0.27 vs. 1.90, p = 0.074). The majority of deaths occurred in medical facilities (88,976 deaths, 77.06%) and in older adults with CMR (5.8). CONCLUSION: Mortality trends in AD increased from 1999 to 2024. Higher trends occurred in men, urban areas, Midwest region, NH Black population and medical facilities.