Abstract 14945: Geographic Disparity in Mortality From Aortic Diseases in the United States

Abstract

Introduction: Aortic diseases (AD) have a high mortality rate. Previous studies have reported that winter season and/or lower temperature climates were associated with a higher incidence of hospitalization due to AD. It remains unclear whether this observation can be translated into higher mortality rate in the country level. Hypothesis: We hypothesized that AD mortality might be higher in areas of the United States with colder climates or longer winter seasons. Methods: The underlying cause of death file in the CDC WONDER online database was queried between 2015 and 2019. AD deaths were identified by listing aortic aneurysm and dissection (ICD-10 code: I71) as underlying cause of death among persons aged ≥ 35 years. We calculated age-adjusted mortality rate (AAMR) at the Census region level and stratified by sex and race-ethnicity groups (non-Hispanic White, non-Hispanic Black, and Hispanic) per 100,000 population. Adjusted linear regression model by sex and race/ethnicity groups was used to examine the association between AAMR and Census region. We also calculated state-level AAMR of AD, and compared AAMRs in top-5 warmest states with those in the top-5 coldest states in winter. Results: A total of 46,708 AD deaths were identified between 2015 and 2019. AAMR in Midwest was the highest (4.7), followed by West (4.0), Northeast (3.8), and South (3.7). In comparison with South as a referent, Midwest was significantly associated with higher AAMR after adjusting for gender and race/ethnicity groups (beta coefficient: 0.87 [95% confidence interval: 0.37 - 1.37], p-value = 0.002). State-level AAMR seemed higher in northern part of the US and AAMRs were significantly higher in the coldest states compared with the warmest states in winter (p < 0.05) (Figure). Conclusion: The present study showed that the states with colder climates in winter season was significantly associated with higher AAMR in, suggesting that geographical factors are likely to affect the mortality rate in AD.