Spatiotemporal Analysis of Acute Aortic Syndrome in Jiangsu, China From Medical Record Front Page Registry.

Background

Acute aortic syndrome (AAS) represents a major cardiovascular emergency with significant mortality without timely diagnosis and treatment. Although AAS is well recognized globally, population-based evidence on its incidence, temporal trends, and mortality in China remains limited.

Objectives

The authors aimed to provide province-wide, subtype-specific estimates of hospitalized AAS incidence, temporal trends, and postadmission mortality in Jiangsu Province, eastern China, from 2014 to 2023.

Methods

We conducted a retrospective, province-wide study of hospitalized AAS cases, operationalized as aortic dissection and intramural hematoma, using the Jiangsu provincial Medical Record Front Page registry linked to mortality records across 13 cities. Incidence rates were age- and gender-standardized. Temporal trends were analyzed using joinpoint regression and age effects were estimated through the age-period-cohort model. Mortality was assessed using weighted Kaplan-Meier analyses with landmark.

Results

A total of 19,758 first-ever cases of AAS, comprising aortic dissection and intramural hematoma, were identified from 2014 to 2023. The age- and gender-standardized incidence rate of AAS was 3.30 per 100,000 person-years. The average annual percent change was 11.60%. Incidence was markedly higher in male than in female individuals, and male individuals developed AAS at a younger age. Observed postadmission mortality was lower among surgically treated patients.

Conclusions

This province-wide study characterized the incidence and mortality of hospitalized patients with AAS in Jiangsu Province. The observed increase in hospitalized incidence likely reflected both changes in disease burden and improvements in detection, coding, and subtype classification. Distinct age-, sex-, and subtype-specific patterns support targeted risk-factor management, surveillance, and emergency-care planning.