{
  "abstract": "Objectives To analyse global trends in aortic aneurysm mortality from 1990 to 2021 and project future trends through 2036, examining variations across Socio-Demographic Index (SDI) quintiles, regions, nations, age groups and sexes.Design We conducted a comprehensive analysis using mortality data from the Global Burden of Disease (GBD) Study 2021.Setting Data were obtained from the GBD 2021 database, covering 204 countries and territories across 21 GBD regions.Participants Individuals with aortic aneurysm-related mortality between 1990 and 2021.Main outcome measures Absolute deaths and age-standardised mortality rates (ASMR) per 100 000 from 1990 to 2021, stratified by SDI quintiles, GBD regions and individual nations. Temporal trends were quantified using estimated annual percentage change (EAPC) and net drift, while decomposition analysis assessed contributions of population ageing, growth and epidemiological changes to mortality patterns. Risk factor attribution across regions and SDI levels was examined, alongside projections of ASMR and deaths through 2036 using the Nordic prediction method.Results Global aortic aneurysm deaths increased from 88.35 thousand in 1990 to 153.93 thousand in 2021, while ASMR decreased from 2.54 to 1.86 per 100 000 (EAPC: −1.28%). High SDI regions showed significant ASMR declines (EAPC: −1.982%), while low-middle SDI regions experienced increases (EAPC: 1.272%). Marked regional variations were observed, with Australasia showing the largest decrease (EAPC: −4.114%) and Central Asia the highest increase (EAPC: 2.498%). Japan diverged from other developed countries with significant mortality increase. Decomposition analysis revealed that increased mortality was primarily driven by population growth (59.109 million) and ageing (46.385 million), partially offset by epidemiological improvements (−39.92 million). The male-to-female ASMR ratio decreased globally from 2.45 to 2.00. Tobacco remained the leading risk factor globally, while body mass index emerged as an increasing concern. Projections indicate a slight global ASMR decrease by 2036, with concerning increases in regions like high-income Asia Pacific and South Asia.Conclusions Despite declining global ASMR, the absolute burden of aortic aneurysm mortality continues to grow with significant regional and sex-based disparities. These findings highlight the need for targeted interventions, particularly in regions facing increasing mortality rates, and emphasise the importance of addressing modifiable risk factors while strengthening healthcare infrastructure in vulnerable areas.",
  "authors": [
    {
      "affiliations": [
        "Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Xiaoqin Zhou"
    },
    {
      "affiliations": [
        "Department of Pediatric Cardiovascular Surgery, Children’s Heart Center, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China"
      ],
      "name": "Weiqiang Ruan"
    },
    {
      "affiliations": [
        "Department of Pediatric Cardiovascular Surgery, Children’s Heart Center, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China"
      ],
      "name": "Jianfeng Pu"
    },
    {
      "affiliations": [
        "Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Ting Wang"
    },
    {
      "affiliations": [
        "Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Huizhen Liu"
    },
    {
      "affiliations": [
        "Center of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Jing Li"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Ke Lin"
    },
    {
      "affiliations": [
        "Department of Pediatric Cardiovascular Surgery, Children’s Heart Center, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China"
      ],
      "name": "Shuhua Luo"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China"
      ],
      "name": "Jing Lin"
    }
  ],
  "title": "Worldwide trends in mortality for aortic aneurysm from 1990 to 2021 and projections to 2036: a systematic analysis of data from the Global Burden of Disease Study 2021",
  "uid": "cba680a9-dee6-5712-8dfb-17badf21bdc0"
}