Trends in Non-Traumatic Acute Subdural Hemorrhage Mortality in the U.S.: A Retrospective Analysis
Muzamil Akhtar1, Isra Masood2, Danish Ashraf3, Ifrah Ansari4, Mohsin Ali5, Fatima Hussain2, Syed Zaeem Ahmed4
1Gujranwala Medical College, Gujranwala, Pakistan, 2Dow International Medical College, Karachi, Pakistan, 3Foundation University Medical College, Islamabad, Pakistan, 4Dow Medical College, Karachi, Pakistan, 5Bolan Medical College, Quetta, Pakistan
Objective:
To examine trends in mortality related to non-traumatic acute subdural hemorrhage (SDH) in the United States from 1999 to 2020, analyzing key demographic factors.
Background:
Non-traumatic acute SDH occurs in the absence of external head trauma and is commonly associated with conditions such as aneurysms or coagulopathies. Understanding epidemiological trends is critical for identifying high-risk populations and guiding targeted prevention and management strategies to improve outcomes.
Design/Methods:
Mortality data for non-traumatic acute SDH in adults aged 45 years and older were extracted from the CDC WONDER database, using ICD-10 code I62.0. Age-adjusted mortality rates (AAMR) per 100,000 population were analyzed by gender, year, urbanization, region, and state. Joinpoint regression was used to calculate the annual percentage change (APC) with 95% confidence intervals (CI).
Results:
A total of 88,396 deaths were attributed to this condition from 1999 to 2020. The AAMR increased from 1.8 in 1999 to 3.1 in 2020. A significant rise in AAMR was noted between 1999 and 2002 (APC: 17.7*; 95% CI, 8.1 - 34.7), followed by a modest but steady increase from 2002 to 2020 (APC: 0.6; 95% CI, -0.01 - 1.2). Males had a higher AAMR than females (Male AAMR: 4.9 vs. Female AAMR: 2.5). Nonmetropolitan areas had a higher AAMR compared to metropolitan areas (Nonmetropolitan AAMR: 4.1 vs. Metropolitan AAMR: 3.3). The South region recorded the highest overall AAMR at 3.6, with Alabama having the highest state-level AAMR at 6.2, while Arizona had the lowest at 1.9.
Conclusions:
Mortality from non-traumatic acute SDH significantly increased between 1999 and 2020, with the highest rates observed in males and nonmetropolitan areas. The South region had the highest mortality, with Alabama recording the highest state-level AAMR. These findings highlight the need for targeted interventions in high-risk populations.
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