Temporal Trends in Intracerebral Hemorrhage Related Mortality Rates in United States From 1999 to 2020 - an Analysis of Epidemiological Disparities
Wania Rehman1, MOHAMMAD AMMAR UR RAHMAN1, Talha Shaukat1, Arham Khalid1, Luqman Munir1
1King Edward Medical University
Objective:

This investigation meticulously examines ICH-related death trends from 1999 to 2020, utilizing age-adjusted mortality rates (AAMR) to perceive variations across various demographic factors.

Background:

Intracerebral hemorrhage (ICH), a variant of stroke, ensues from the rupture of diminutive cerebral vessels, precipitating substantial morbidity and mortality. This formidable affliction causes formation of an intraparenchymal hematoma, occasionally extending into the cerebral ventricles.

Design/Methods:

Our study examined CDC Wonder database, analyzing stroke-related Age-Adjusted Mortality Rate (AAMR) implementing Joinpoint Regression Analysis. We assessed Parallelism and computed Annual Percent Changes (APC) with a 95% Confidence Interval. We analyzed ICH mortality data from 1999 to 2020, evaluating major demographic groups (gender, race, age, and urban/rural) trends.

Results:

Between 1999 and 2020, there was an apparent downtrend in the Age-Adjusted Mortality Rate (AAMR) for stroke, marked by an Annual Percent Change (APC) of -3.58 from 1999 to 2012, and -1.16 from 2012 to 2020. A significant decrease was observed in the AAMR, plummeting from 7.4 in 1999 to 4.2 in 2020. Pronounced decline in AAMR among females was seen. Additionally, a shift in trend among black individuals was evident from 2003 to 2012. Metropolitan regions demonstrated substantial mortality decrease prior to 2012 than in subsequent years.

Conclusions:

In the United States, fatalities originating from ICH have seen a decline over the past two decades, a trend possibly attributed to advancements in immunization programs and medical treatments. However, the persistently elevated mortality rates within specific demographic groups emphasize the imperative for further research to rectify this discrepancy.

10.1212/WNL.0000000000211772
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