Abstract 4367044: Cerebral Infarction Mortality Trends in Older Adults in the United States From 1999 to 2020

Abstract

Background: Stroke is the 5 th leading cause of death in the United States and an estimated 160,000 people die annually from it according to the American Heart Association (AHA) and costs the US healthcare system $56 billion annually. 85% of strokes are due to cerebral infarction. We aim to study the patterns of cerebral infarction mortality in older adults from age 55 to 85+ years. Methods: We used the CDC Wonder database and searched from 1999 to 2020 using the ICD-10 code I63. The year 2000 for population and 2013 for urbanization were selected as standards. The outcome of mortality was reported as an age-adjusted rate (AAR) or an age-adjusted mortality rate (AAMR) per 100,000 and that for the ten-year age groups was reported as a crude rate. Results: Mortality trends overall as well as for both genders followed a 15-year decrease, then a 4-year increase (large U-shaped pattern), followed by a yearly decrease-increase pattern (small V-shaped pattern). There was a decreasing mortality trend from 1999 (AAR= 46.8) till 2014 (AAR= 14.8) and then increased till 2018 (AAR= 36.8). There was a decrease in AAR in 2019 (AAR= 32.5) and then an increase in 2020 (AAR= 38.3). Males had higher mortality than the overall and female mortality rates throughout this period (Figure 1). Similarly, all the races followed this decreasing trend till mid-2010, then increased till 2018 followed by a brief dip in 2019 and a spike in 2020. Blacks had the highest mortality of all the races (1999 AAR= 60.2) (2012 AAR= 17.1) (2020 AAR= 51.7). In 2020 after blacks (AAR= 51.7) the second highest mortality rate was for Hispanics (AAR= 37.9), followed closely by whites (AAR= 37.3), then American Indians (AAR= 34), and lastly Asians/Pacific Islanders (AAR= 27.2) (Figure 2). When the mortality in this age group was stratified on the basis of gender in 10-year groups (55-64, 65-74, 75-84, 85+), in the first 3 periods (from 55 till 84 years) males had a higher crude mortality rate than the females but interestingly female mortality surpassed males in 85+ years age group (Figure 3). Conclusion: In people 55 years and above the mortality decreased from 1999 till 2014 and then a brief increase till 2018. Males had more mortality during this period. Blacks had the highest mortality amongst all races. In 10-year age groups males had the highest mortality than females in all groups except 85 years and above where females had more mortality.