title: Global and regional burden of aortic dissection and aneurysms: mortality trends in 21 world regions, 1990 to 2010.
abstract: A comprehensive and systematic assessment of the global burden of aortic aneurysms (AA) has been lacking. Therefore, we estimated AA regional deaths and years of life lost (YLL) in 21 regions worldwide for 1990 and 2010. We used the GBD (Global Burden of Disease) 2010 study causes of death database and the cause of death ensemble modeling approach to assess levels and trends of AA deaths by age, sex, and GBD region. The global AA death rate per 100,000 population was 2.49 (95% CI: 1.78 to 3.27) in 1990 and 2.78 (95% CI: 2.04 to 3.62) in 2010. In 1990 and 2010, the highest mean death rates were in Australasia and Western Europe: 8.82 (95% CI: 6.96 to 10.79) and 7.69 (95% CI: 6.11 to 9.57) in 1990 and 8.38 (95% CI: 6.48 to 10.86) and 7.68 (95% CI: 6.13 to 9.54) in 2010. YLL rates by GBD region mirrored the mortality rate pattern. Overall, men had higher AA death rates than women: 2.86 (95% CI: 1.90 to 4.22) versus 2.12 (95% CI: 1.33 to 3.00) in 1990 and 3.40 (95% CI: 2.26 to 5.01) versus 2.15 (95% CI: 1.44 to 2.89) in 2010. The relative change in median death rate was +0.22 (95% CI: 0.10 to 0.33) in developed nations versus +0.71 (95% CI: 0.28 to 1.40) in developing nations. The smallest relative changes in median death rate were noted in North America high income, Central Europe, Western Europe, and Australasia, with estimates of +0.07 (95% CI: -0.26 to 0.37), +0.08 (95% CI: -0.02 to 0.23), +0.09 (95% CI: -0.02 to 0.21), and +0.22 (95% CI: -0.08 to 0.46), respectively. The largest increases were in Asia Pacific high income, Southeast Asia, Latin America tropical, Oceania, South Asia, and Central Sub-Saharan Africa. Women rather than men drove the increase in the Asia Pacific high-income region: the relative change in median rates was +2.92 (95% CI: 0.6 to 4.35) versus +1.05 (95% CI: 0.61 to 2.42). In contrast to high-income regions, the observed pattern in developing regions suggests increasing AA burden, which portends future health system challenges in these regions.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA. Electronic address: u.sampson@vanderbilt.edu.
authors.forename: Uchechukwu K A
authors.initials: UK
authors.lastname: Sampson
authors.affiliation: School of Surgery, University of Western Australia, Fremantle, Western Australia, Australia.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Norman
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: F Gerald R
authors.initials: FG
authors.lastname: Fowkes
authors.affiliation: Department of Cardiology, Dupuytren University Hospital and INSERM U1094, Tropical Neuro-epidemiology, Limoges, France.
authors.forename: Victor
authors.initials: V
authors.lastname: Aboyans
authors.affiliation: Department of Biostatistics, VUMC, Nashville, TN, USA.
authors.lastname: Yanna Song
authors.affiliation: Department of Biostatistics, VUMC, Nashville, TN, USA.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Harrell
authors.affiliation: Institute for Health Metrics and Evaluation, Seattle, WA, USA.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Forouzanfar
authors.affiliation: Institute for Health Metrics and Evaluation, Seattle, WA, USA.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Naghavi
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, CA, USA.
authors.forename: Julie O
authors.initials: JO
authors.lastname: Denenberg
authors.affiliation: Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: McDermott
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, CA, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Mensah
authors.affiliation: Institute for Health Metrics and Evaluation, Seattle, WA, USA; School of Public Health, Imperial College London, United Kingdom.
authors.forename: Majid
authors.initials: M
authors.lastname: Ezzati
authors.affiliation: Institute for Health Metrics and Evaluation, Seattle, WA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Murray
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality*; D001014:Aortic Aneurysm / Q000401:mortality*; D017281:Cost of Illness; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017678:Sex Distribution; D015996:Survival Rate