Addressing inequities in neurological mortality: trends and disparities in anoxic brain injury deaths, 1999-2023.

Abstract

Purpose: Despite the slowly declining prevalence of anoxic brain injury (ABI) due to newer drugs and guidelines, there still exists inequity in timely receipt of treatment. This study aims to provide a comprehensive evaluation of ABI mortality trends and sociodemographic disparities in the United States from 1999 to 2023.

Methods: Mortality data were obtained from the CDC-WONDER Database. The study focused on ABI-related deaths among adults aged 35 to 85 + years between 1999 and 2023. Demographic and regional variables were analyzed, including gender, race/ethnicity, age groups, census region, state, urbanization, and place of death. Average annual percentage changes (AAPC) were calculated, and trends were evaluated using the Joinpoint Regression.

Results: From 1999 to 2023, there were a total of 117,148 ABI-related deaths. The overall age-adjusted mortality rate (AAMR) showed a mild increase from 1999 to 2004, followed by a sharp increase until 2017, and a subsequent decline (APC: -3.10% [95% CI, -4.1% to -2.37%]. Males consistently exhibited higher mortality rates compared to females. Significant racial disparities were observed, with African Americans demonstrating higher AAMRs (7.67) than other racial groups. Both urban and rural areas experienced trends in ABI mortality, with rural areas showing higher AAMRs.

Conclusion: Despite recent declines in overall ABI mortality trends, significant disparities persist across demographic and geographic lines. Targeted public health interventions are necessary to address risk factors leading to ABI, particularly among high-risk groups such as racial minorities and rural populations.