National Trends in Ischemic Brain Injury and Cardiac Arrest Related Mortality in The United States from 1999–2024 : Insights From The CDC WONDER Database
Aiza Ahsan1, Muhammad Izhan1, Raveen Mujeeb1, Sakina Shaikh1, Arham Kamil1
1Dow Medical College, Dow University of Health Sciences
Objective:
To assess national trends and demographic disparities in ischemic brain injury and cardiac arrest related mortality among U.S. adults from 1999 to 2024.
Background:
Ischemic brain injury is a devastating neurologic sequela of cardiac arrest and a key determinant of survival. Despite advances in neurocritical care, national trends and demographic disparities in related mortality remain poorly understood.
Design/Methods:
Mortality data for adults aged ≥25 years were obtained from the CDC WONDER database (1999–2024) using ICD-10 code G93.1 for ischemic brain injury and 146 for cardiac arrest. Age-adjusted mortality rates (AAMR) per 100,000, Average and Annual percentage changes (AAPC, APCs) along with 95% CI were calculated using the Joinpoint regression and stratified by age, gender, race, census, state, and urbanisation.
Results:
A total of 291,741 deaths were recorded, with 89.1% occurring in medical facilities. Overall AAMR rose from 4.35 in 1999 to 5.10 in 2024. AAMR declined from 1999–2004 (APC –1.97; 95% CI –4.27 to –0.55; p=0.007), rose sharply during 2004–2014 (APC 3.78; 95% CI 3.34–4.91; p<0.001), increased modestly in 2014–2021 (APC 1.10, 95% CI 0.26–1.87; p=0.016), and declined again in 2021–2023 (APC –5.12, 95% CI –7.90 to –3.23; p<0.001). Males exhibited higher mortality rates than females (AAMR 6.03 vs 4.05), while adults ≥65 years bore the greatest burden (AAMR 13.87). Non-Hispanic Black adults exhibited the highest AAMR (9.72), followed by Hispanics (4.70), Non-Hispanic Others (4.47), and Non-Hispanic Whites (4.40). AAMR was highest in the South (5.27) and lowest in Northeast (4.08). Urban areas had higher AAMR (4.91) than rural (4.76). At the state level, AAMRs were highest in Kansas (16.1) and lowest in Vermont (1.81).
Conclusions:
Ischemic brain injury and cardiac arrest related mortality has risen over the past two decades, with persistent demographic disparities. These findings call for targeted interventions focused on high-risk populations to improve recovery outcomes and reduce preventable deaths.
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