Abstract
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Despite an overall decline, VID mortality remains high among women, NH American Indians, rural areas, and the Midwest-underscoring the need for targeted interventions.