Temporal Trends and Racial Disparities of Ischemic Stroke in the 45+ age group of population from 1999 to 2020: Nationwide Analysis from CDC WONDER Database
Jay Kakadiya1, Sanskar Patel1, Denish Godhaviya1, Smit Bhalala1, Kush Varsadiya2
1Government Medical College, Surat, 2Shri M.P. Shah Medical College, Jamnagar
Objective:
The objective is to analyse trends of mortality attributable to stroke in United States.
Background:
Stroke is the 2nd leading cause of death and disability worldwide. Approximately, 9.6 million ischemic strokes are estimated globally each year. Timely estimates of trends in the burden are essential to make evidence-based healthcare policy, planning, and resource allocation.
Design/Methods:
Extensive data analysis was conducted for mortality due to stroke in the 45+ age population from 1999 to 2020 using the CDC WONDER database. Joinpoint regression is used to calculate annual percentage change (APC).
Results:
The pattern of stroke-related Age-adjusted mortality rates (AAMR) has changed over the previous twenty years. Average APC is decreased by 0.64 for males and females, however upward trends are observed in last 7 years (2014 - 2020) with an increase in APC of 18.9 (95% CI: 12.2 – 26.1) for males and 18.8 (95% CI: 11.9 – 26.1) for females. Age-group-wise analysis revealed the highest CDR of 142.2 in people >85 years of age. The AAMR is higher in non-Hispanics (NH) as compared to Hispanic population (16.7 vs 13.5). Importantly, the highest AAMR of 21.4 is experienced by NH African Americans followed by NH Whites (16.4). Hispanic American Indians have the lowest AAMR with only 2.3 (95% CI: 1.8 -2.9). Males have relatively higher AAMR than females (17.5 vs 15.6) A total of 45% deaths are occurred in inpatient hospital settings, followed by nursing homes however, Emergency room has lowest. Washington has the highest AAMR (23.3) followed by Vermont, South Dakota. The Lowest AAMR is observed in Rhode Island (11.5) followed by Wyoming, Utah.
Conclusions:
Elderly, NH African American, males have experienced higher mortality rates as compared to young, Hispanic, and females. APC has been in rising pattern in the last 7 years. Periodic monitoring, targeted management is needed to cut down mortality rates.
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