Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas, USA; Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
World Neurosurg. 2024 May;185:e620-e630. doi: 10.1016/j.wneu.2024.02.094. Epub 2024 Feb 24.
Stroke is a leading cause of morbidity and mortality in the United States among older adults. However, the impact of demographic and geographic risk factors remains ambiguous. A clear understanding of these associations and updated trends in stroke mortality can influence health policies and interventions.
This study characterizes stroke mortality among older adults (age ≥55) in the US from January 1999 to December 2020, sourcing data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research. Segmented regression was used to analyze trends in crude mortality rate and age-adjusted mortality rate (AAMR) per 100,000 individuals stratified by stroke subcategory, sex, ethnicity, urbanization, and state.
A total of 3,691,305 stroke deaths occurred in older adults in the US between 1999 and 2020 (AAMR = 233.3), with an overall decrease in AAMR during these years. The highest mortality rates were seen in nonspecified stroke (AAMR = 173.5), those 85 or older (crude mortality rate1276.7), men (AAMR = 239.2), non-Hispanic African American adults (AAMR = 319.0), and noncore populations (AAMR = 276.1). Stroke mortality decreased in all states from 1999 to 2019 with the greatest and least decreases seen in California (-61.9%) and Mississippi (-35.0%), respectively. The coronavirus pandemic pandemic saw increased stroke deaths in most groups.
While there's a decline in stroke-related deaths among US older adults, outcome disparities remain across demographic and geographic sectors. The surge in stroke deaths during coronavirus pandemic reaffirms the need for policies that address these disparities.
在美国，中风是导致老年人发病率和死亡率的主要原因。然而，人口统计学和地理风险因素的影响仍不明确。清楚地了解这些关联以及中风死亡率的最新趋势可以影响卫生政策和干预措施。
本研究描述了 1999 年 1 月至 2020 年 12 月期间美国年龄在 55 岁及以上的中风死亡率，数据来源于疾病控制与预防中心广泛在线流行病学研究数据。使用分段回归分析了按中风亚类、性别、族裔、城市化程度和州分层的每 10 万人的粗死亡率和年龄调整死亡率（AAMR）的趋势。
1999 年至 2020 年期间，美国共有 3691305 例中风死亡（AAMR=233.3），AAMR 在此期间总体呈下降趋势。死亡率最高的是未特指中风（AAMR=173.5）、85 岁及以上人群（粗死亡率 1276.7）、男性（AAMR=239.2）、非西班牙裔非裔美国人（AAMR=319.0）和非核心人群（AAMR=276.1）。1999 年至 2019 年，所有州的中风死亡率均有所下降，加利福尼亚州（-61.9%）和密西西比州（-35.0%）的下降幅度最大和最小。冠状病毒大流行期间，大多数人群的中风死亡人数都有所增加。
尽管美国老年人群中风相关死亡人数有所下降，但在人口统计学和地理方面仍存在差异。冠状病毒大流行期间中风死亡人数的激增再次证实，需要制定解决这些差异的政策。
