Thoracic Aortic Disease in Australia Epidemiology, Mortality and Economic Burden : The Hereditary Syndromic, Non-Syndromic and Degenerative Causes

Abstract

Thoracic Aortic Disease (TAD) is often a silent disease that can be rapidly fatal. International data reveals an illness that is under-recognised and disproportionately resource-intensive. However, no Australia-wide data exists on the extent of the problem domestically. Therefore, this research seeks to quantify the epidemiology, mortality, admissions, economic and disease burden to understand Australia's situation better.

Methods

An actuarial survival and population data-linkage analysis was performed using the International Classification of Diseases, Australian Bureau of Statistics, Australian Institute of Health and Welfare, and Medicare Benefits Schedule to assess epidemiology and hospital admissions between 2010 and 2020. Economic costs and burden were calculated using proportional Global Burden of Disease Study data, Australian Independent Hospital and Aged Care Pricing Authority and the Human Capital Approach.

Results

Approximately 1,900/100,000 males and 930/100,000 females live with TAD in Australia, with an overall TAD prevalence of 1/360. About 420 people die annually. In the ten years, there were 16,738 hospital admissions and 17,125 surgeries, both rising. The average length of stay was 10.7 days, 4.4 times longer than average. TAD resulted in 1,967 years of life lost and 5,966 disability-adjusted life years in 2019-20. Total medical costs were $881 million, $51,769 per admission. TAD accounted for 71% of all I71 medical costs but only 35% of all I71 admissions. TAD cost 2022AU$2.1 billion in lost productivity, peaking at $398 million in 2020; males cost $ 1.1 million per death and $122,000 per survivor; females cost $655,000 per death and $118,000 per survivor.

Discussion

This thesis confirmed that Australia also has a rising incidence, morbidity and cost of TAD, ensuring this as a disproportionate resource-intense disease, which requires a concerted multidisciplinary approach to reduce the mortality, morbidity and expense to the country.