Multiple Cause Of Death Database Research Articles

Risk of suicide among stroke survivors in the United States

BackgroundStroke is the largest cause of disability and the 5th leading cause of death in the United States. Suicide is the 12th leading cause of death in the United States. However, little is known about the risk of suicide among people with a prior stroke. ObjectivesUsing Multiple Cause of Death data (1999-2020) from the Centers for Disease Control and Prevention WONDER database, we examined via cross-sectional analysis the risk of suicide among survivors of stroke as compared to the general U.S. population and among subgroups within the United States. MethodsWe assessed disparities in suicide rate among patients with stroke stratified by sex, race, urbanization levels, and census regions using the CDC WONDER multiple cause of death database. Standardized mortality rates were calculated to compare the suicide rate of stroke patients with the rates among demographic-matched cohorts and the general United States population. ResultsAs compared to the general population, stroke survivors had an elevated risk of suicide. Black stroke survivors had a lower rate of suicide as compared to the general population, while White stroke survivors and those in nonmetropolitan areas had an elevated risk compared to the general population. ConclusionThere was a slightly elevated risk of suicide among people with a prior stroke in the United States. This risk may be elevated among White people and among people living in nonmetropolitan areas.

Race-Specific Mortality from Multiple Myeloma: A CDC Database Population Study in the United States between 2000 and 2020

Background: Multiple myeloma is the second most prevalent hematologic cancer, following lymphoma, with a median overall survival of 5 to 10 years. Multiple myeloma prognosis has markedly changed over time. Despite that, there are significant racial inequalities in the incidence and overall survival of all different types and stages of the disease. Interestingly, it is twice as prevalent and fatal among African-Americans as White. In the lack of studies examining racial disparities in racial subgroups, we conducted a retrospective study to assess mortality trends across all racial groups in the United States between 2000 and 2020. Method: We performed a retrospective study utilizing the Centers for Disease Control and Prevention (CDC) database. Employing the multiple cause of death database (ICD-10 revision codes), we identified all patients who died of Multiple Myeloma (C90.0.x listed as the underlying cause of death) of all races (White, Black, Asian or Pacific Islander, and American Indian or Alaska Native) between 2000 and 2020 in the United States regardless of Hispanic origin and gender. Age-adjusted mortality rates were calculated per 1000,000 persons (PMP), standardized to the US census data from 2000, and stratified by race. Result: Between 2000 and 2020, a total of 237,496 multiple myeloma deaths were identified in all races, with an overall age-adjusted mortality of 33.4 PMP. We identified a total of 189,964 deaths, 41,823 deaths, 4,558 deaths, and 1,151 deaths in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations respectively. The overall age-adjusted mortalities were 31.1 PMP, 62.1 PMP, 16 PMP, and 22.7 PMP in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations respectively. Furthermore, over the 20 years, the age-adjusted mortality decreased by 26 % in Black (from 74.5 PMP in 2000 to 54.8 PMP in 2020), 22 % in White (from 35.2 PMP in 2000 to 27.5 PMP in 2020), 12 % in Asian or Pacific Islander (from 16.3 PMP in 2000 to 14.4 PMP in 2020), and 52 % in American Indian or Alaska Native (from 28.8 PMP in 2000 to 13.9 PMP in 2020). Conclusion: This comprehensive population-based study demonstrates that there are racial disparities in multiple myeloma mortality. Within the past two decades, the mortality was highest among African Americans and lowest among Asians and Pacific Islanders. Moreover, all racial groups had a decrease in mortality trends. American Indian Alaskans had the highest rate of decrease, which was double that of blacks. Multiple factors can contribute to the disparities including but not limited to the interplay between disease biology, risk factors, treatment response, and unequal access to innovative therapies. Further studies are needed to investigate the causes of the racial disparities and identify strategies to minimize the racial gap.

Racial Disparities in Mortality Trends from Acute Myeloid Leukemia: A Population-Based Study in the United States between 2000 and 2019

Background: Acute myeloid leukemia (AML) results from the clonal alteration of hematopoietic progenitors and is the most prevalent form of acute leukemia in adults. Despite breakthroughs in therapeutic regimens and advancements in overall survival, the improvement has not been equally distributed among racial and ethnic groups, and the 5-year survival rate for adults with AML remains at 27%. Interestingly, the incidence is greater among whites when adjusted for age compared to other races. Racial inequalities in patients with solid malignancies are well-studied, but studies assessing racial disparities in hematologic malignancies are lacking. Therefore, we conducted a retrospective analysis of mortality trends among all racial groups in the United States from 2000 to 2019. Methods: We conducted a retrospective analysis employing the Centers for Disease Control and Prevention's (CDC) WONDER database, which covers the entire US population. Using the multiple cause of death database (International Classification of Disease - 10th revision), we identified all patients who died of AML (C92.0.x listed as the underlying cause of death) of all races (White, Black, Asian, or Pacific Islander, and American Indian or Alaska Native) between 2000 and 2019 in the United States, regardless of ethnicity and gender. Age-adjusted mortality rates were calculated per 1000,000 persons (PMP), standardized to the US census data from 2000, and stratified by race. Results: A total of 176,526 AML deaths were identified in all races, with an overall age-adjusted mortality of 26.7 PMP between 2000 and 2019. Over the same period, we identified a total of 156,453 deaths, 14,079 deaths, 5,280 deaths, and 714 deaths in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations, respectively. The overall age-adjusted mortality were 27.7 PMP, 20.9 PMP, 19 PMP, and 13.6 PMP in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations, respectively. Over this period, the age-adjusted mortality increased by 3 % in White (from 26.1 PMP in 2000 to 27 PMP in 2019), 3 % in Black (from 20.8 PMP in 2000 to 21.4 PMP in 2019), and 25 % in Asian or Pacific Islander (from 15 PMP in 2000 to 18.7 PMP in 2019), and decreased by 29 % in American Indian or Alaska Native (from 18 PMP in 2000 to 12.7 PMP in 2019). Conclusion: This is one of the largest subgroup-based racial population studies analyzing AML mortality trends. Between 2000 and 2019, the AML mortality was the highest in Whites and the lowest in American Indians or Alaska Natives. Furthermore, the American Indian or Alaska Native is the only race that showed a decline in the mortality trends. The mortality trends increased equally in White and Black American. The highest rate of increase was seen in the Asian or Pacific Islander. Multiple variables might contribute to the inequalities, including but not limited to the interaction of genetics, risk factors, response to therapy, socioeconomic status, and disparate access to health care and novel treatment regimens. Further studies are warranted to evaluate the causes of racial disparities and develop methods to reduce the gap.

Abstract 15312: Racial Disparities in Trends in Mortality From Cardiac Arrests in the United States

Background: African Americans are at increased risk of fatal cardiac arrests, but population-based studies exploring contemporary epidemiology are not available. We sought to identify the trend in race-specific mortality from cardiac arrest in the United States. Methods: Using the multiple cause of death database, we identified all patients (Caucasians or African Americans) who died of cardiac arrest (International Classification of Diseases, 10th revision code I46.x listed as underlying cause of death) between 1999 and 2018. Age-adjusted mortality rates were standardized to the 2000 US census data, and stratified by age group (<35 years, 35-64 years, and ≥ 65 years). Results: A total of 311,065 cardiac arrest deaths were identified, with an overall age-adjusted mortality of 53.6 per million (Caucasian: 49.1 per million, African American: 90.6 per million). Overall, age-adjusted mortality decreased from 80.1 per million persons (1999) to 44.3 per million persons (2012), followed by 8.8% increase to 48.2 (2018). Between 2012 and 2018, African Americans had higher rates of increase (10.9%) compared with Caucasians (6.9%). Largest disparities in relative changes between 2012 and 2018 occurred in patients younger than 35 years (African American: 35%, Caucasians -11%), and patients ≥ 65 years (African Americans: 8%, Caucasians 4%), figure. Conclusions: Although the mortality due to cardiac arrest has declined in the US between 1999 and 2012, a recent increase has been noted between 2012 and 2018, particularly among younger African Americans. Studies should focus on identifying causes of disparities and identifying methods to reduce the racial gap.

EPIDEMIOLOGY AND TRENDS OF AORTIC STENOSIS MORTALITY IN THE UNITED STATES (1999-2016)

Despite major advances in cardiovascular care, aortic stenosis (AS) is still associated with high morbidity and mortality. Aortic stenosis-related mortality in the United States is unknown. Using the multiple cause of death database, we identified all patients (45 years and older) who died of

PULMONARY EMBOLISM MORTALITY IN THE UNITED STATES (1999-2015): ANALYSIS OF THE MULTIPLE CAUSE OF DEATH DATA

Background: Pulmonary embolism (PE) is associated with high morbidity and mortality. We sought to describe the trends in PE mortality in the US. Method: Using the multiple cause of death database, we identified all patients who died of pulmonary embolism using the International Classification of

Mortality Trends of Acute Respiratory Distress Syndrome in the United States from 1999-2013

Acute respiratory distress syndrome (ARDS) is an acute hypoxemic respiratory failure seen in critically ill patients after an inciting injury. The burden of ARDS mortality in the United States in recent years is not well characterized. In this study, we aimed to describe trends in the annual incidence of ARDS mortality in the United States from 1999 to 2013. We also describe demographic characteristics, geographic and seasonal trends, and other associated underlying causes of death in this population. Data on all deceased U.S. residents are available through the Multiple Cause of Death (MCOD) database of the National Center for Health Statistics. ARDS-related deaths were identified in the MCOD database using International Classification of Diseases, 10th Revision. Aggregate annual crude and age-adjusted mortality rates and mortality rate ratios were used to compare various demographic subpopulations. Over the 15-year period, the national ARDS-related age-adjusted mortality rate demonstrated an annual seasonal variation, peaking in winter. The annual rate decreased in a nonlinear fashion, with a plateau from 2010 to 2013. The ARDS-related age-adjusted mortality rate was 5.01 per 100,000 persons (95% confidence interval, 4.92-5.09) in 1999 and 2.82 per 100,000 persons (95% confidence interval, 2.76-2.88) in 2013. Males had a higher average ARDS-related mortality rate than did females. Asian/Pacific Islanders had the lowest average age-adjusted ARDS-related mortality rate, and black/African-American individuals, the highest. National age-adjusted ARDS-related mortality rates decreased between 1999 and 2013 in the United States, yet still show relative racial and sex disparities. However, death certificates largely underestimate the overall mortality burden from ARDS when compared with studies of clinically ascertained cases.