Demographic and Regional Variations in the Temporal Trends of Traumatic Brain Injury-related Mortality in the United States: 1999 to 2020
Muhammad Sameer Almas1, Areeba Shams Sarwari2, Zain Nadeem1, Farwa Naveed3, Eeman Ahmad4, Hassan Tariq5
1Allama Iqbal Medical College, 2Ziauddin University, 3Dow University of Health Sciences, 4Fatima Memorial Hospital College ofMedicine and Dentistry, Lahore, Pakistan, 5Faisalabad Medical University
Objective:
We aim to identify the temporal trends in mortality associated with traumatic brain injuries (TBI) in the United States (US) stratified by sex, age, race/ethnicity, geographical region.
Background:
TBI is projected to remain as one of the top three causes of injury-related death and disability up to 2030, with a high burden on the children and elderly.
Design/Methods:
We used the CDC-WONDER database to obtain death certificate data of all decedents with TBI mentioned either as an underlying or a contributing cause of death. Crude (CMR) and age-adjusted mortality rates (AAMR) with 95% confidence intervals (CIs) were calculated per 100,000. Temporal trends were analyzed using Joinpoint regression to obtain the annual percent change (APC) and the average APC (AAPC) in the rates.
Results:
From 1999 to 2020, a total of 1,238,469 deaths associated with TBI were recorded in the US, with an AAMR of 17.8 (95% CI: 17.7 to 17.8). The AAMR remained stable till 2010, followed by an increase thereafter till 2020 (APC: 1.17). Males showed nearly thrice the AAMR (27.9) than females (8.7). The highest AAMR was showed by non-hispanics (NH) American Indians or Alaska Natives (26.7) and the lowest by NH Asians or Pacific Islanders (8.8). Individuals above 85 years showed the highest CMR (118.5). Regional variation was also evident (South: 20.2, Midwest: 17.8, West: 17.7, Northeast: 13). Non-metropolitan regions showed greater AAMR (25.2) than metropolitan ones (16.5).
Conclusions:
The mortality rates associated with TBIs remained stable initially, but increased from 2010 onwards. We observed the highest mortality rates in males, NH American Indians and Alaska Natives, individuals above 85 years, residents of the South, and those living in non-metropolitan regions. Preventive efforts and effective policies should be targeted towards the high-risk groups to reduce the burden of disease.
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