Surgical Anastomosis, Bypass, or Graft–Related Mortality: Temporal Trends and Demographic Disparities in the United States, 1999–2024

Abstract Background Surgical operations involving anastomosis, bypass, or graft are performed across several specialties, but national mortality patterns associated with later complications of these procedures have not been well described. This study examined long-term trends and demographic and geographic differences in mortality recorded under International Classification of Diseases, Tenth Revision code Y83.2 in the United States. Methods Death-certificate data for adults aged 25 years or older were obtained from the CDC WONDER Multiple Cause of Death database for 1999–2024. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population and standardized to the 2000 U.S. population. Joinpoint regression was used to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). Analyses were performed overall and by sex, race and ethnicity, census region, urbanization status, state, and place of death. Urbanization data were available through 2020. Results The annual overall extract included 87,980 deaths. The AAMR declined from 2.744 in 1999 to 0.872 in 2015 (APC, − 7.56%; 95% CI, − 8.38% to − 6.72%), increased to 2.021 in 2020 (APC, 22.30%; 95% CI, 13.79% to 31.46%), and then declined to 0.713 in 2024 (APC, − 25.80%; 95% CI, − 31.25% to − 19.92%). The overall AAPC was − 5.61% (95% CI, − 7.34% to − 3.86%). Males had higher AAMRs than females throughout the study period. Non-Hipanic (NH) Black individuals had the smallest long-term racial and ethnic decline and the highest AAMR in 2024. Nonmetropolitan areas had higher AAMRs than metropolitan areas during 1999–2020. The West experienced the steepest temporary regional increase, and Mississippi had the highest pooled state-level AAMR. Conclusion Mortality associated with surgical operations involving anastomosis, bypass, or graft declined significantly between 1999 and 2024, although the long-term improvement was interrupted by a marked increase beginning in the mid-to-late 2010s. Persistent differences across demographic and geographic groups indicate that the mortality burden was not distributed evenly.