Abstract：
OBJECTIVE: Aortic dissection and aortic aneurysm rupture are aortic emergencies and their clinical outcomes have improved over the past two decades; however, whether this has translated into lower mortality across countries remains an open question. The purpose of this study was to compare mortality trends from aortic dissection and rupture between the UK, Japan, the USA and Canada.
METHODS: We analysed the WHO mortality database to determine trends in mortality from aortic dissection and rupture in four countries from 2000 to 2019. Age-standardised mortality rates per 100 000 persons were calculated, and annual percentage change was estimated using joinpoint regression.
RESULTS: Age-standardised mortality rates per 100 000 persons from aortic dissection and rupture in 2019 were 1.04 and 1.80 in the UK, 2.66 and 1.16 in Japan, 0.76 and 0.52 in the USA, and 0.67 and 0.81 in Canada, respectively. There was significantly decreasing trends in age-standardised mortality from aortic rupture in all four countries and decreasing trends in age-standardised mortality from aortic dissection in the UK over the study period. There was significantly increasing trends in mortality from aortic dissection in Japan over the study period. Joinpoint regression identified significant changes in the aortic dissection trends from decreasing to increasing in the USA from 2010 and Canada from 2012. In sensitivity analyses stratified by sex, similar trends were observed.
CONCLUSIONS: Trends in mortality from aortic rupture are decreasing; however, mortality from aortic dissection is increasing in Japan, the USA and Canada. Further study to explain these trends is warranted.
METHODS: We analysed the WHO mortality database to determine trends in mortality from aortic dissection and rupture in four countries from 2000 to 2019. Age-standardised mortality rates per 100 000 persons were calculated, and annual percentage change was estimated using joinpoint regression.
RESULTS: Age-standardised mortality rates per 100 000 persons from aortic dissection and rupture in 2019 were 1.04 and 1.80 in the UK, 2.66 and 1.16 in Japan, 0.76 and 0.52 in the USA, and 0.67 and 0.81 in Canada, respectively. There was significantly decreasing trends in age-standardised mortality from aortic rupture in all four countries and decreasing trends in age-standardised mortality from aortic dissection in the UK over the study period. There was significantly increasing trends in mortality from aortic dissection in Japan over the study period. Joinpoint regression identified significant changes in the aortic dissection trends from decreasing to increasing in the USA from 2010 and Canada from 2012. In sensitivity analyses stratified by sex, similar trends were observed.
CONCLUSIONS: Trends in mortality from aortic rupture are decreasing; however, mortality from aortic dissection is increasing in Japan, the USA and Canada. Further study to explain these trends is warranted.
摘要：
目的：主动脉夹层和主动脉瘤破裂是主动脉急症，在过去的二十年中，其临床结果有所改善；然而，这是否已经转化为各国死亡率的降低仍然是一个悬而未决的问题。这项研究的目的是比较英国之间主动脉夹层和破裂的死亡率趋势，Japan,美国和加拿大。
方法：我们分析了WHO死亡率数据库，以确定2000年至2019年四个国家主动脉夹层和破裂的死亡率趋势。计算了每10万人的年龄标准化死亡率，并使用连接点回归估算年度百分比变化。
结果：2019年每10万人主动脉夹层和破裂的年龄标准化死亡率在英国分别为1.04和1.80。2.66和1.16在日本，0.76和0.52在美国，加拿大为0.67和0.81，分别。在研究期间，所有四个国家的主动脉破裂的年龄标准化死亡率均呈显着下降趋势，而英国的主动脉夹层的年龄标准化死亡率呈下降趋势。在研究期间，日本主动脉夹层的死亡率有显著增加的趋势。Joinpoint回归分析发现，美国从2010年开始，加拿大从2012年开始，主动脉夹层趋势从减少到增加的显着变化。在按性别分层的敏感性分析中，观察到类似的趋势。
结论：主动脉破裂死亡率呈下降趋势；然而，在日本，主动脉夹层的死亡率正在上升，美国和加拿大。需要进一步研究来解释这些趋势。
方法：我们分析了WHO死亡率数据库，以确定2000年至2019年四个国家主动脉夹层和破裂的死亡率趋势。计算了每10万人的年龄标准化死亡率，并使用连接点回归估算年度百分比变化。
结果：2019年每10万人主动脉夹层和破裂的年龄标准化死亡率在英国分别为1.04和1.80。2.66和1.16在日本，0.76和0.52在美国，加拿大为0.67和0.81，分别。在研究期间，所有四个国家的主动脉破裂的年龄标准化死亡率均呈显着下降趋势，而英国的主动脉夹层的年龄标准化死亡率呈下降趋势。在研究期间，日本主动脉夹层的死亡率有显著增加的趋势。Joinpoint回归分析发现，美国从2010年开始，加拿大从2012年开始，主动脉夹层趋势从减少到增加的显着变化。在按性别分层的敏感性分析中，观察到类似的趋势。
结论：主动脉破裂死亡率呈下降趋势；然而，在日本，主动脉夹层的死亡率正在上升，美国和加拿大。需要进一步研究来解释这些趋势。
