Abstract
BACKGROUND: Aortic aneurysm (AA) remains a significant global cause of mortality. This study aimed at systematically revealing the distribution of AA burden and its attributable risk factors from 1990 to 2021. METHODS: Data of AA-related deaths, disability-adjusted life years (DALYs), and corresponding age-standardized rates (ASRs) were extracted from the Global Burden of Disease (GBD) 2021 study. Estimated annual percentage change (EAPC) was calculated to assess trends in the AA burden at global, regional, and national levels. The temporal trends of AA burden were analyzed, and key attributable risk factors were identified. Population attributable fractions (PAFs) were calculated to assess the impact of these risk factors. RESULTS: From 1990 to 2021, global AA-related deaths increased by 74.218% (95% UI: 83090‒93492 to 138413‒165739), while age-standardized death rates (ASDR) declined by 26.772% (95% UI: 2.538 to 1.861 per 100000). DALYs rose by 64.944% (95% UI: 1784177‒2006704 to 2857320‒3353858), with ASDALYR falling by 25.1% (95% UI: 48.789 to 36.543 per 100000). Regions with high or middle-high socio-demographic index (SDI) scores experienced higher AA burdens compared to lower SDI regions. Males had higher burdens, peaking at ages 70‒74 (deaths) and 65‒69 (DALYs). In regions with an SDI above 0.75, the ASRs of AA burden exhibited a downward trend. Smoking was identified as the most significant attributable risk factor. CONCLUSION: From 1990 to 2021, declining trends were observed in the ASRs of AA-related deaths and DALYs, although males reported a higher AA burden than females. Efforts to control tobacco use should be prioritized as a key preventive strategy.