Rath Shree, Sameen Dur E, Waseem Neha, Ahsan Sahar, Syed Bushra, Khalid Farooq Arham, Kamal Ahmad
All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India.
Jinnah Medical and Dental College, Karachi, Pakistan.
Neurol Sci. 2025 Oct;46(10):5235-5242. doi: 10.1007/s10072-025-08382-6. Epub 2025 Jul 26.
Despite the slowly declining prevalence of anoxic brain injury (ABI) due to newer drugs and guidelines, there still exists inequity in timely receipt of treatment. This study aims to provide a comprehensive evaluation of ABI mortality trends and sociodemographic disparities in the United States from 1999 to 2023.
Mortality data were obtained from the CDC-WONDER Database. The study focused on ABI-related deaths among adults aged 35 to 85 + years between 1999 and 2023. Demographic and regional variables were analyzed, including gender, race/ethnicity, age groups, census region, state, urbanization, and place of death. Average annual percentage changes (AAPC) were calculated, and trends were evaluated using the Joinpoint Regression.
From 1999 to 2023, there were a total of 117,148 ABI-related deaths. The overall age-adjusted mortality rate (AAMR) showed a mild increase from 1999 to 2004, followed by a sharp increase until 2017, and a subsequent decline (APC: -3.10% [95% CI, -4.1% to -2.37%]. Males consistently exhibited higher mortality rates compared to females. Significant racial disparities were observed, with African Americans demonstrating higher AAMRs (7.67) than other racial groups. Both urban and rural areas experienced trends in ABI mortality, with rural areas showing higher AAMRs.
Despite recent declines in overall ABI mortality trends, significant disparities persist across demographic and geographic lines. Targeted public health interventions are necessary to address risk factors leading to ABI, particularly among high-risk groups such as racial minorities and rural populations.
尽管由于新药和指南的出现，缺氧性脑损伤（ABI）的患病率在缓慢下降，但在及时接受治疗方面仍存在不公平现象。本研究旨在全面评估1999年至2023年美国ABI的死亡率趋势和社会人口统计学差异。
死亡率数据来自疾病控制与预防中心的WONDER数据库。该研究聚焦于1999年至2023年35岁至85岁及以上成年人中与ABI相关的死亡。分析了人口统计学和区域变量，包括性别、种族/族裔、年龄组、人口普查区域、州、城市化程度和死亡地点。计算了平均年度百分比变化（AAPC），并使用Joinpoint回归评估趋势。
1999年至2023年，共有117,148例与ABI相关的死亡。总体年龄调整死亡率（AAMR）在1999年至2004年略有上升，随后急剧上升直至2017年，随后下降（APC：-3.10%[95%CI，-4.1%至-2.37%]）。男性的死亡率一直高于女性。观察到显著的种族差异，非裔美国人的AAMR（7.67）高于其他种族群体。城市和农村地区都经历了ABI死亡率的趋势，农村地区的AAMR更高。
尽管近期ABI总体死亡率呈下降趋势，但在人口统计学和地理区域方面仍存在显著差异。有必要采取针对性的公共卫生干预措施来解决导致ABI的风险因素，特别是在少数族裔和农村人口等高风险群体中。
