Regional and Temporal Trends in Brain Abscess-related Mortality among Adults in the US from 1999 to 2020
Obaid Rehman1, Zain Nadeem2, Khawaja Abdul Rehman3, Muhammad Bilal Sardar2, Adeena Jamil4, Eeshal Fatima1, Syed Inam5, Muhammad Inam Ul Haq5
1Services Institute of Medical Sciences, 2Allama Iqbal Medical College, 3CMH Lahore Medical College and Institute of Dentistry, 4Dow International Medical College, 5Marshall Neurology
Objective:
We aimed to identify temporal trends in Brain Abscess (BA)-related mortality among US adults ( ≥25 years) stratified by year, sex, race, age, and region.
Background:
BA is a neurological and infectious disorder characterized by pus formation in cerebral tissue, with an estimated one-year mortality rate of 20%.
Design/Methods:
Using data from the CDC WONDER database, we determined crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 1,000,000 individuals from 1999-2020. We used Joinpoint regression to examine the changes in AAMR through annual percent change (APC) and average annual percent change (AAPC).
Results:
From 1999 to 2020, a total of 13,856 BA-related deaths were reported in the US, with an overall AAMR of 2.92 (AAPC = 1.67). The AAMR remained stable until 2015 (APC 0.62, 95% CI -1.22 to 1.29), but increased thereafter till 2020 (APC 5.10, 95% CI 2.16 to 12.30). The AAMR in males (4.03) was over twice that in females (2.00). Non-Hispanic (NH) American Indians or Alaskan Natives showed the highest AAMR (5.56) while NH Asian or Pacific Islanders showed the lowest (1.81). Regional variation in AAMRs was evident (West: 3.50, South: 2.86, Midwest: 2.81, and Northeast: 2.51). The highest CMR was observed in individuals older than 85 (10.53), followed closely by those aged 75 to 84 (9.87). Residents of rural areas showed slightly higher AAMR (3.03) than those of urban areas (2.95). Most deaths occurred in inpatient medical facilities (9,798).
Conclusions:
An overall increasing mortality trend was observed with a sharp increase in the AAMR from 2015 to 2020. The highest mortality rates were found in NH American Indians or Alaska Natives, males, those older than 85 years, residents of the West, and those living in rural areas. Public health initiatives should aim to improve equitable access to preventative and therapeutic interventions for high-risk individuals.
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