Trend and Geographic Disparities in the Mortality Rates of Primary Systemic Vasculitis in the United States from 1999 to 2019: A Population-Based Study.

Alicia Rodriguez-Pla,Jose Rossello-Urgell

doi:10.3390/jcm10081759

Abstract

The current data on rates and geographic distribution of vasculitis mortality are limited. We aimed to estimate the mortality rates of primary systemic vasculitis and its geographic distribution using recent population data in the United States. The mortality rates of vasculitis from 1999 to 2019 were obtained from the Center for Disease Control (CDC) Wonder Multiple Cause of Death (MCD). The age-adjusted rates per million for vasculitis as MCD and as an underlying cause of death (UCD) were calculated by state using demographics. A joinpoint regression analysis was applied to evaluate trends over time. The age-adjusted mortality rate of vasculitis as MCD was 4.077 (95% CI: 4.029–4.125) and as a UCD was 1.888 per million (95% CI: 1.855–1.921). Since 1999, mortality rates have progressively decreased. The age-adjusted mortality rate was higher in females than in males. The highest mortality rate for vasculitis as MCD was in White patients (4.371; 95% CI: 4.317–4.424). The northern states and areas with lower populations had higher mortality rates. We found a trend of progressive decreases in the mortality rates of vasculitis, as well as gender, racial, and geographic disparities. Further analyses are warranted to better understand the factors associated with these disparities in order to implement targeted public health interventions to decrease them.

Highlights

The age-adjusted mortality rate of vasculitis as Multiple Cause of Death (MCD) was 4.077 per million and as the underlying cause of death (UCD) was
Using earlier versions of the same database of our current study, we previously reported a progressive decrease in the mortality rates for vasculitis as the UCD
In our two previous reports about vasculitis mortality [18,19], we found that the vasculitis mortality rates were very low in Hispanic patients, which was found in another study on associated vasculitis (AAV) mortality [21]

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Primary systemic vasculitides are a group of heterogeneous disorders characterized by inflammation of the vessel wall. According to the 2012 International Chapel Hill Consensus. Conference on the Nomenclature of Vasculitides, vasculitides are classified by the size of the vessel primarily involved in large-, medium-, and small-vessel vasculitis [1]. Large-vessel vasculitis primarily affects the aorta and supra-aortic branches.

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