Trends and Demographics of Vascular Intestinal Diseases-Related Mortality Among Adults Living in United States From 1999 to 2020; A CDC Wonder Analysis.

Vascular intestinal disorders (VID), including mesenteric ischemia, ischemic colitis, and intestinal angiodysplasia, have a global incidence of 8.11/100 000/year and a mortality of 1.26/100 000/year (15.5% death rate), rising from ~1% to ~3% in childhood to ~50% after 95 years. In the US, the incidence of acute vascular insufficiency of the intestine (AVII) is rising, warranting detailed trend analysis. CDC WONDER death certificates (1999-2020) for adults > 25 years were analyzed using ICD-10 code N55. Age-adjusted mortality rates (AAMRs) per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.2.0) calculated annual percent changes (APCs); significance was defined as p < 0.05. Overall AAMR declined from 9.35 (1999) to 5.81 (2020). Women had higher AAMRs (7.63; 95% CI: 7.6-7.66) than men (6.5; 95% CI: 6.49-6.56). By race/ethnicity, AAMRs were highest in NH American Indian (7.89; 95% CI: 7.57-8.21), NH Black (7.84; 95% CI: 7.75-7.9), NH White (7.25; 95% CI: 7.22-7.28), Hispanic (5.91; 95% CI: 5.83-6), and NH Asian (3.59; 95% CI: 3.5-3.68). Micropolitan areas had higher AAMRs (7.92) than metropolitan (6.99). Regional AAMRs were highest in the Midwest (7.7; 95% CI: 7.65-7.75), followed by South (7.17; 95% CI: 7.13-7.21), West (7.02; 95% CI: 6.96-7.07), and Northeast (6.85; 95% CI: 6.79-6.9). Kentucky had the highest state AAMR (9.67; 95% CI: 9.43-9.9), Hawaii the lowest (4.59; 95% CI: 4.31-4.87). Oklahoma, Rhode Island, Tennessee, West Virginia, and Wyoming ranked in the top 90th percentile. Despite an overall decline, VID mortality remains high among women, NH American Indians, rural areas, and the Midwest-underscoring the need for targeted interventions.