Trends and Disparities in Cerebrovascular Accident Related Mortality in Epilepsy Patients in USA from 1999-2020: Insights from CDC WONDER database
Ushna Khan1, Esha Umair2, Muhammad Ahmed2, Bisma Aslam2, Fizza Javid2, Ali Raza2, Zainab Saleem2, Esha Razia2, Rumaisa Ahmed2, Asma Khan2, Syed Muhammed Salman Hassan2, Muhammad Awais Danish2, Khubaib Ahmad3, Shazib Ali4
1University of Florida, 2Nishtar Medical University Multan, 3Marshfield Clinic, 4Allama Iqbal Medical College
Objective:

This study assesses trends and sociodemographic disparities in U.S. adult mortality from CVAs co-occurring with epilepsy (1999–2020), highlighting inequities by sex, race, region, and urbanization to inform equitable interventions for epilepsy care barriers.

 

 

Background:
Cerebrovascular accidents (CVAs) are a leading cause of epilepsy, particularly late onset epilepsy, contributing to the U.S. mortality burden. This study aims to analyze the mortality rates in patients affected with both. 
Design/Methods:
A descriptive study was conducted using CDC WONDER data from 1999–2020, including adults aged ≥25 years. Mortality was identified using ICD-10 codes I60–I69 (CVA) and G40 (Epilepsy). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, race, census region, and urbanization. Joinpoint regression estimated annual percent changes (APCs) with 95% confidence intervals (CIs).
Results:

Between 1999 and 2020, 7,138 deaths (3,744 females; 3,394 males) in the U.S. were attributed to both epilepsy and cerebrovascular accidents, among U.S. adults aged ≥25. The AAMR in females declined from 0.10 in 1999 to 0.09 in 2011 (APC: 0.45), before rising to 0.31 in 2020 (APC: 14.38). The AAMR in males declined from 0.13 in 1999 to 0.1 in 2008 (APC: -5.43), then increased to 0.36 in 2020 (APC: 12.27). Among racial groups, Black/African American had the highest AAMR (0.77), followed by White (0.29), Hispanic/Latino (0.26), while the Asian/Pacific Islanders had the lowest AAMR (0.17). Regionally, AAMRs were highest in the West (0.43) and South (0.34), followed by Midwest (0.28), with the lowest in the Northeast (0.27). The Midwest showed the highest AAPC (5.67), followed by the South (5.46), and West (4.91). For urbanization, AAPC was highest in Large Fringe Metro areas (6.57), followed by Medium Metro (6.34), and Large Central Metro (5.58). 

 

Conclusions:

Epilepsy with cerebrovascular accidents has shown fluctuating mortality trends with recent increases across both sexes and regions, highlighting disparities and targeted prevention needs. 

 

10.1212/WNL.0000000000216045
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.