Aortic dissection mortality in the United States, 1968-2023: Trends, disparities, and deep learning forecasts

Authors

Abdalhakim Shubietah, Advocate Health - MidwestFollow
Mohamed S. Elgendy, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abubakar Nazir, Oli Health Magazine Organization, Kigali, Rwanda.
Ahmed Ahmed, Department of Medicine, Al-Quds University, East Jerusalem, West Bank, Palestine.
Ameer Awashra, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
Mustafa Alkhawam, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, USA.
Sarah Saife, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
Hamza A. Abdul-Hafez, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
Mohamed Saad Rakab, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Mohammed AbuBaha, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
Mohammed Tareq Mutar, College of Medicine, University of Baghdad, Baghdad, Iraq.
Ahmed Emara, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Recommended Citation

Shubietah A, Elgendy MS, Nazir A, et al. Aortic dissection mortality in the United States, 1968-2023: Trends, disparities, and deep learning forecasts. Int J Cardiol Cardiovasc Risk Prev. 2025;27:200547. Published 2025 Nov 14. doi:10.1016/j.ijcrp.2025.200547

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: The population-level burden and inequities of aortic dissection (AD) mortality in the United States remain incompletely defined, and contemporary, data-driven forecasts are scarce.

Methods: Using the CDC WONDER Death database (1968-2023), AD deaths were identified by ICD codes (ICD-8/9: 441.0; ICD-10: I71.0). Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, race, age, and Census region. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average APC (AAPC). Forecasts through 2033 employed a Bi-GRU model.

Results: We analyzed 175,930 AD-related deaths. Overall, the national AAMR declined by 43 % across 1968-2023 (AAPC -1.10 %, 95 % CI -1.19 to -1.00) but showed a recent upturn (APC +2.00 %, 95 % CI 1.53-2.57). Mortality remained higher in men than women and in Black than White individuals, increased steeply with age, and varied geographically. Bi-GRU forecasts project a modest national decline in AAMR from 1.62 to 1.47 by 2033, with persistent sex (men 1.91 vs women 1.12) and racial (Black 2.32 vs White 1.35) gaps; a slight increase is confined to the South (1.62 → 1.64), while rates in adults ≥85 years improve (10.26 → 9.70).

Conclusions: While U.S. AD mortality has nearly halved over five decades, recent increases and persistent demographic and regional disparities highlight uneven progress. Forecasts to 2033 suggest modest overall declines with persistent sex and racial gaps; targeted hypertension control and regional access to high-volume aortic centers remain priorities.

Type

Article

PubMed ID

41333716