JMIR Publications

ABSTRACT

Background:

Aortic pathologies in general and acute aortic syndromes in particular persist to be a relevant concern globally from a public health perspective. Continuous efforts to monitor and update incidence rates are necessary for guided public health interventions and healthcare policy adaptions.

Objective:

This study aims to evaluate temporal patterns in the incidence and outcomes of rup-tured aortic aneurysms (rAA) and aortic dissections (AD) in Austria over a 15-year pe-riod with a focus on population-wide trends.

Methods:

This study provides a retrospective, population-wide analysis of aortic syndromes us-ing national healthcare data from 2009 to 2023. The data was provided by a federal data warehouse that stores all recorded in-hospital services in Austria. We analyzed annual and population-adjusted incidence rates, in-hospital mortality, comorbidities, complications, and demographic characteristics for rAA and AD cases. Temporal pat-terns were assessed for annual variations. Exploratory forecasts were made until 2030 using exponential smoothing time series models.

Results:

Corresponding to global trends the proportion of individuals of 65 years of age and older slightly increased from 17.4% in 2009 to 19.6% in 2023. The incidence of rAA decreased by 18.2%, with incidence rates falling from 4.3 to 3.2 per 100,000 (-25.2%) over the study period. In-hospital mortality among rAA patients declined from 38.7% to 34.6%, accompanied by a decrease in major comorbidities and recorded in-hospital complications. The incidence of hospital-admitted AD, however, showed a significant increase of 102.8%, with population adjusted incidence rates rising from 5.2 to 9.6 per 100,000 (+85.6%). In-hospital mortality for aggregated AD cases decreased slightly from 12.1% to 11.0%.

Conclusions:

While rAA incidence and mortality declined, AD cases showed a substantial increase, suggesting changing epidemiological trends that warrant further investigation.