M. Fatima2, H. Ahmer1, H. A. Cheema3, A. Khalid2, E. Moazzam2, M. Azhar3, H. A. Maqsood5, A. Z. Syeda4, M. W. Murad6, S. A. Naqi2 1Mayo Clinic, Surgery, Rochester, MN, USA 2King Edward Medical University, Surgery, Lahore, PUNJAB, Pakistan 3King Edward Medical University, Medicine, Lahore, PUNJAB, Pakistan 4University Of Pennsylvania, Surgery, Philadelphia, PA, USA 5Yale New Haven Health, Department Of Surgery, New Haven, CT, USA 6Shanxi Medical University, Medicine, Taiyuan, SHANXI, China
Introduction:
Peripheral Vascular Disease (PVD) is linked with an elevated likelihood of heart failure, coronary artery disease (CAD), cerebrovascular disease (CVD), critical limb ischemia, and a general two- to threefold rise in mortality over a span of 5 to 10 years.The data regarding peripheral vascular disease (PVD) related mortality trends is limited. This study seeks to define the present-day patterns in mortality, considering various sociodemographic factors and geographical areas.
Methods:
Data was extracted from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database for the period spanning 1999 to 2021. The dataset was categorized by demographic factors such as age, gender, race/ethnicity as well as regional classifications like state and census. Data was obtained from Multiple Cause Data sets 1999-2020 and 2021. ICD code 173 was used with PVD as an underlying cause of death. Both crude (CMR) and age-adjusted (AAMR) mortality rates were calculated per 100,000 individuals. The associated yearly percentage changes (APC) and average annual percentage (AAPC) were calculated using the Joinpoint Regression Program Version 4.9.0.0, a software used for trend analysis.
Results:
From 1999-2021, a total of 164,002 PVD-related deaths were reported. There was an overall decrease in AAMR from 2.55 per 100,000 individuals to 1.86 per 100,000 individuals (APC: -1.62, 95%CI: -2.08, -1.15) with a significant decrease from 2004-2009 (APC: -4.73, 95%CI: -6.73, -3.06) and 2009-2021(APC: =-0.83, 95%CI: -1.12, -.047). A similar decrease in mortality trends was observed in other subgroups, however, male, NH(non-Hispanic) black, and census region south demonstrated an overall high AAMR (Male AAPC: -1.5, 95%CI: -2.4,0.4, NH Black AAPC: -2.59, 95%CI: -2.98,-2.21, Census South AAPC: -1.91, 95%CI : -3.11, -0.70) in their respective subgroups. Additionally, the age group 80-84 years was associated with the highest crude mortality rate among all age groups however a significant decrease in CMR was observed from 2005 onwards.The overall trend in crude mortality rate remained relatively constant over the years in the younger age group (45-49, 50-54, 55-59, 60-64, 65-69, 70-74) as compared to the older age group (75 and older).
Conclusion:
Though there has been a significant decline in mortality attributed to PVD in this nationwide population-based analysis of death certificate data, however, inequities continue to exist among various demographic and regional categories, underscoring the need for additional examination.The rates of mortality linked to PVD was disproportionately higher among male, individuals identifying as non-Hispanic Black and African American, as well as older individuals.
