Trends In Mortality Research Articles

Deciphering the lung microbiota in COVID-19 patients: insights from culture analysis, FilmArray pneumonia panel, ventilation impact, and mortality trends

Few studies have analyzed the role of the lung microbiome in the diagnosis of pulmonary coinfection in ventilated ICU COVID-19 patients. We characterized the lung microbiota in COVID-19 patients with severe pneumonia on invasive mechanical ventilation using full-length 16S rRNA gene sequencing and established its relationship with coinfections, mortality, and the need for mechanical ventilation for more than 7 days. This study included 67 COVID-19 ICU patients. DNA extracted from mini-bronchoalveolar lavage fluid and endotracheal aspirates was amplified by PCR with specific 16S primers (27F and 1492R). General and relative bacterial abundance analysis was also conducted. Alpha diversity was measured by the Shannon and Simpson indices, and differences in the microbiota were established using beta diversity. A linear discriminant analysis (LDA) effect size algorithm was implemented to describe biomarkers. Streptococcus spp. represented 51% of the overall microbial abundance. There were no differences in alpha diversity between the analyzed variables. There was variation in bacterial composition between samples that had positive and negative cultures. The genera Veillonella sp., Granulicatella sp., Enterococcus sp. and Lactiplantibacillus sp., with LDA scores > 2, were biomarkers associated with negative cultures. Rothia sp., with an LDA score > 2, was a biomarker associated with mortality.

Application of machine learning in breast cancer survival prediction using a multimethod approach

Breast cancer is one of the most prevalent cancers with an increasing trend in both incidence and mortality rates in Iran. Survival analysis is a pivotal measure in setting appropriate care plans. To the best of our knowledge, this study is pioneering in Iran, introducing a multi-method approach using a Deep Neural Network (DNN) and 11 conventional machine learning (ML) methods to predict the 5 year survival of women with breast cancer. Supplying data from two centers comprising a total of 2644 records and incorporating external validation further distinguishes the study. Thirty-four features were selected based on a literature review and common variables in both datasets. Feature selection was also performed using a p value criterion (< 0.05) and a survey involving oncologists. A total of 108 models were trained. According to external validation, the DNN model trained with the Shiraz dataset, considering all features, exhibited the highest accuracy (85.56%). While the DNN model showed superior accuracy in external validation, it did not consistently achieve the highest performance across all evaluation metrics. Notably, models trained with the Shiraz dataset outperformed those trained with the Tehran dataset, possibly due to the lower number of missing values in the Shiraz dataset.

Trends in papillary thyroid cancer mortality in Denmark according to stage and education.

Few studies exist on trends in papillary thyroid cancer (PTC) survival and mortality according to stage and level of socioeconomic status. Nationwide cohort study. Patients diagnosed with PTC during 2000-2015 in Denmark were identified from the Danish Cancer Registry and followed until the end of 2020. We evaluated 5-year all-cause mortality and relative survival according to stage and 5-year mortality rates with corresponding average annual percentage changes (AAPCs) according to stage and education. Finally, we assessed the association between several factors and mortality of PTC using Cox regression. For the 2006 cases of PTC diagnosed during 2000-2015, relative survival tended to increaseand mortality rates tended to decrease for all stages. For localized PTC, mortality rates tended to decrease among individuals with medium education (AAPC = -7.0, 95% confidence interval [CI]: -14.7 to 1.5), but showed an increasing pattern among individuals with long education (AAPC = 19.8, 95%CI: -4.2 to 50.0). For nonlocalized PTC, mortality rates showed a decreasing tendency among individuals with medium and long education (AAPC = -5.5, 95%CI: -13.2 to 2.9, and AAPC = -10.4, 95%CI: -20.8 to 1.4, respectively). Being diagnosed with PTC in a more recent calendar period and long education were associated with a lower mortality rate in the Cox regression analysis. A pattern of an increasing relative survival and decreasing mortality rates of PTC across all stages was seen in Denmark during 2000-2015. The decreasing pattern in mortality rates was most evident in individuals with localized stage and medium education, and in individuals with nonlocalized stage and medium or long education.

Causes and Trends of Mortality among Iranian Older Adults from 2000 to 2019

Causes and Trends of Mortality among Iranian Older Adults from 2000 to 2019

Demographic and Regional Trends of Cardiovascular Disease and Obesity-Related Mortality in the United States From 1999 to 2021

Demographic and Regional Trends of Cardiovascular Disease and Obesity-Related Mortality in the United States From 1999 to 2021

Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder

COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.

National trends in surgical treatment and clinical outcomes among patients with aneurysmal subarachnoid hemorrhage in the Republic of Korea.

In this study, changes in treatment methods and patient prognosis were analyzed using a Korean nationwide medical insurance information database. Patients with subarachnoid hemorrhage who received surgical treatment for cerebral aneurysm from 2005 to 2020 were included. The specific surgery type was classified using the surgical code and according to whether stents were used. Yearly trends in mortality rates and poor prognosis, using tracheostomy as proxy, were analyzed by a simple regression analysis. A multistep logistic regression analysis was performed to evaluate the risk factors of mortality and poor prognosis. Overall, 83,587 patients were included. Females were predominant (64.5%). Microsurgical clip usage rate decreased by approximately two-thirds from 78.8% in 2005 to 24.4% in 2020. Contrarily, endovascular treatment proportion gradually increased, and stent-assisted coil embolization rate surpassed microsurgical clip usage rate in 2020 (24.6% vs. 24.4%). In the multivariate analysis, endovascular treatment correlated positively with 3-month mortality (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 1.07-1.19, P<0.0001), although correlated negatively with poor prognosis (tracheostomy) (HR: 0.93, 95% CI: 0.89-0.98, P=0.0050). According to the treatment trend analysis, during the 16 years studied, for patients with subarachnoid hemorrhage due to ruptured cerebral aneurysm, the endovascular treatment rate increased rapidly and stent-assisted coil embolization rate surpassed that of microsurgical clip ligation. Diversification of treatment methods has led to a decrease in mortality and improved prognosis.

Mortality trends among Indian Medical Association member doctors in India (2018-2023): Implications of the COVID-19 pandemic

Mortality trends among Indian Medical Association member doctors in India (2018-2023): Implications of the COVID-19 pandemic

Cervical Cancer Mortality Among US Women Younger Than 25 Years, 1992-2021

This study examines trends in cervical cancer mortality in US women aged younger than 25 years before and after the introduction of human papillomavirus vaccines.

Nationwide mortality following acute type B aortic dissection and the survival advantage of obesity among dialysis patients in Japan.

The incidence of acute type B aortic dissection is higher than that of acute type A aortic dissection among patientson dialysis. However, the impact of beingonchronic dialysis on outcomes after type B aortic dissection remains unknown. This study aimed to investigate the trends in in-hospital mortality after type B aortic dissection and the association between body mass index (BMI) and survival paradox on dialysis. This study included 48,889 type B aortic dissection hospitalizations in Japan from 2010 to 2020 based on data from a nationwide administrative database. Logistic regression was used to examine mortality risks and restricted cubic spline to investigate the non-linear association between mortality and BMI. There were 2,116 in-hospital deaths, and the mortality rates were 8.0% in patients receiving chronic dialysis and 4.3% in patients not receiving dialysis. Patients not receiving dialysis had decreased trends of absolute mortality. Meanwhile, patients receiving chronic dialysis had a higher mortality rate from 2010 to 2020. The mortality risk was high in patients receiving chronic dialysis who were underweight and had normal BMI, but not in those who were overweight. Restricted cubic spline analysisshowed that a higher BMI was associated with a lower mortality risk in dialysis patients. This finding contrasted the U-shape observed in patients not receiving dialysis. A lower BMI was associated with a higher risk of in-hospital mortality after type B aortic dissection among dialysis patients, thereby illustrating the obesity paradox. Our findings provide insights that can enhance the management strategies for dialysis patients facing type B aortic dissection.

Temporal changes in the burden of leukaemia and lymphoma in the Australasia and Oceania regions, 2010–2019: an analysis of the Global Burden of Disease Study 2019

ObjectivesLeukaemias and lymphomas are among the most prevalent and significant cancers in Australasia and Oceania. This study aims to examine the burden of leukaemias/lymphomas and its temporal trend in Australasia...

National and Subnational Trends of Mortality and Years of Life Lost Due to Stroke and Its Subtypes in Young Adults in China, 2005-2020.

The incidence of stroke among young adults was rising globally, but the death burden of stroke in young adults in China is lacking. We aimed to examine the temporal trends in mortality and years of life lost (YLLs) caused by stroke among young adults from 2005 to 2020 across China. Based on the data from the National Mortality Surveillance System in China, we estimated the number and age-standardized rate of mortality and YLLs due to stroke and its subtypes among young adults aged 15-49 years during 2005-2020, for both China and its 31 mainland provinces. During 2005-2020, the age-standardized mortality rate of stroke among young adults aged 15-49 years in China decreased by 21.0%, from 5.9/100,000 to 4.7/100,000, and the YLL rate decreased from 286.9/100,000 to 229.5/100,000. The age-standardized mortality rate among young adults due to intracerebral hemorrhage (ICH) showed a significant downward trend with a decrease of 26.3% while that of ischemic stroke (IS) and subarachnoid hemorrhage (SAH) decreased by 4.5% and 0.6%, respectively. In 2020, the mortality rate of ICH was 3.5 times higher than that of IS (3.3/100,000 vs 0.9/100,000) among young adults in China. The male/female ratio of age-standardized mortality rate of stroke in young adults increased from 2.0 in 2005 to 3.1 in 2020. The age-standardized mortality rate of IS and SAH in young men increased by 11.0% and 2.5%, respectively. In 2020, Tibet (18.4/100,000), Jilin (10.4/100,000), and Qinghai (8.3/100,000) were the top 3 provinces holding the highest age-standardized mortality rate due to stroke among young adults. Tibet was found to have the highest mortality rate due to ICH and SAH while that of IS was higher in northeast China. In China, the death burden caused by ICH among young adults was substantially higher than that of IS. The increasing death burden of IS and SAH among young men requires special attention. Evidence-based intervention strategies are needed to improve the outcomes of stroke and alleviate the death burden due to stroke among young adults in Chinese population.

Temporal trend and attributable risk factors of cardiovascular diseases burden for adults 55 years and older in 204 countries/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021.

The aging global population and overall population growth have significantly increased the burden of cardiovascular diseases (CVDs). This study aims to examine global temporal trends in the incidence, disability-adjusted life years (DALY), and mortality rates of both overall and type-specific CVDs among adults aged 55 and older from 1990 to 2021, with a focus on identifying changes over time, regional disparities, and the key risk factors contributing to this burden. We analyzed data from the Global Burden of Disease (GBD) Study 2021, covering 204 countries and territories. Trends in age-standardized rates of incidence, DALY, and mortality for both overall and specific types of CVDs were assessed, alongside the impact of key risk factors. Between 1990 and 2021, global age-standardized incidence, DALY, and mortality rates showed a declining trend, with estimated annual percentage changes (EAPCs) of -0.39, -1.30, and -1.11, respectively. However, due to overall population growth and aging, the absolute number of CVD cases continued to rise. Regions with high-middle Socio-demographic Index (SDI) exhibited the highest incidence and mortality rates, while high SDI regions saw the greatest declines. Men had higher age-standardized rates of CVDs incidence, DALY, and mortality compared to women. The burden increased with age, with the oldest age groups (80+ years) showing the highest rates. High systolic blood pressure was the leading modifiable risk factor, contributing to more than half of the CVD-related DALY globally. Other major risk factors included high low-density lipoprotein cholesterol, smoking, and ambient particulate matter pollution. While age-standardized rates of CVD incidence, DALY, and mortality have declined over the past three decades, the total burden of CVDs continues to rise due to population aging and growth. These findings highlight the need for targeted prevention strategies in regions with high CVD burden, particularly those with lower socioeconomic status.

Burden of Digestive Diseases in the United States Population: Rates and Trends.

Digestive diseases are common in the United States (U.S.) and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to expand on earlier findings and investigate rates and trends in the digestive disease burden in the U.S. The Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the U.S.: Multiple Cause-of-Death Data, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care, and mortality with a digestive disease diagnosis. Digestive disease prevalence (claims-based, 2019) was 24.2% among Medicaid beneficiaries, 33.2% among private insurance enrollees, and 51.5% among Medicare beneficiaries and rose over the previous decade. Digestive diseases contributed to 42 million emergency department visits, 17 million hospital stays, and 472,000 deaths in 2019. Women had higher medical care rates with a digestive disease diagnosis, but mortality rates were higher among men. Blacks had higher medical care use and mortality rates compared with Whites, and Hispanics had lower rates. During the study period, ambulatory care and emergency department visit rates with a digestive disease diagnosis rose, while hospitalization and mortality rates declined. Among private insurance enrollees, rates were higher compared with national data for hospitalizations, but lower for emergency department visits. The digestive disease burden in the U.S. is substantial, particularly among Blacks and older adults. Further research is needed to better understand reasons for disparities and trends in health care use and mortality reported in this paper.

Analysis on trends of mortality rate and disease burden of liver cancer in Tianjin, China from 1999 to 2021

Objective: To explore the trends and distribution of liver cancer between sexes, ages, and urban-rural areas in Tianjin, China from 1999 to 2021, and provide data for targeted prevention and control strategies of liver cancer in Tianjin. Methods: Liver cancer mortality data of Tianjin during 1999-2021 were from the Tianjin population based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC), and the population data of permanent Tianjin residents were from Tianjin Municipal Public Security Bureau. Liver cancer mortality, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALY) were calculated using the cause of death surveillance data collected by Tianjin Centers for Disease Control and Prevention. The distributions of these data among residents of different sexes, ages, and regions were analyzed. Segi's world standard population was used for standardization. Joinpoint regression was used for trend analysis on the mortality rate of liver cancer and the disease burden. Results: The liver cancer mortality rate in Tianjin decreased by 46.75% from 1999 to 2021, with distinct phased characteristics. From 1999 to 2010, the age-sex-standardized mortality rate (SMR) decreased from 12.62/100 000 to 11.64/100 000 with an annual percent change (APC) of -1.32% (P=0.003). From 2010 to 2021, the SMR decreased from 11.64/100 000 to 6.72/100 000 (APC=-3.89%, P＜0.001). The age-sex-standardized DALY rates(SDR) decreased by 50.63% from 1999 to 2021, also with distinct phased characteristics. From 1999 to 2010, the SDR decreased from 388.67/100 000 to 349.38/100 000 (APC=-1.35%, P=0.002). From 2010 to 2021, the SDR decreased from 349.38/100 000 to 191.88/100 000 (APC=-4.43%, P＜0.001). The liver cancer mortality rate declined most rapidly in the age group under 45 years; the APC for those under 35 years was -5.07% (P＜0.001), and for those aged 35-44 years, the APC was 0.63% (P=0.707) and -8.21% (P＜0.001) before and after 2007, respectively. Both SMR and SDR were significantly higher in males than in females (P＜0.01). Both SMR and SDR were significantly higher in urban areas than in rural areas from 1999 to 2007 (P＜0.05), but they became similar after 2008. Liver cancer DALY are predominantly YLL, accounting for 99%. The median age of liver cancer deaths in Tianjin during 1999-2021 was 64-68 years old, with males lower than females (P＜0.05), and rural areas lower than urban areas (P＜0.05), generally showing an increasing trend (1999-2014: APC=0.11%, P=0.047; 2014-2021: APC=0.51%, P=0.005). Conclusions: Liver cancer mortality rate and disease burden decreased from 1999 to 2021 in Tianjin, with an especially accelerated decline after 2010. Further efforts to reduce liver cancer mortality in Tianjin are needed, and special attention should be focused on the elderly, male, and rural residents.

Trends in utilization and impact of hospital procedural volume on mortality after endovascular thrombectomy for acute ischemic stroke

ObjectivesEndovascular thrombectomy (EVT) has become an established treatment for eligible acute ischemic stroke (AIS) patients, but data on mortality trends and the association between procedural volume and outcomes in the United States is limited. Materials and MethodsThis retrospective study analyzed data from the Nationwide Readmissions Database (NRD) to investigate trends in EVT utilization, outcomes, and the relationship between hospital procedural volume and inpatient mortality for AIS admissions between 2016-2020. Patients undergoing EVT were identified using ICD-10 procedure codes. Hospitals were categorized into quintiles based on EVT volumes, and mortality rates compared across quintiles. Multivariable regression identified predictors of mortality. ResultsOf 2,535,777 AIS admissions, 90,110 (3.6 %) underwent EVT (median age of 70 and 50 % female in both groups). EVT utilization increased from 2.8 % in 2016 to 3.9 % in 2020 (p < 0.001). Patients receiving EVT had higher prevalence of atrial fibrillation and coronary artery disease but lower rates of hyperlipidemia and tobacco use. Inpatient mortality was higher with EVT (13 % vs 4 %, p < 0.001) but declined from 16 % in 2016-2017 to 12 % in 2020 (p < 0.001). Hemiparalysis and atrial fibrillation were associated with higher EVT likelihood. Mortality decreased with higher hospital EVT volume. After adjustment, higher procedural centers were associated with lower mortality. ConclusionEVT utilization for AIS increased nationally from 2016-2020 while associated mortality declined. Higher hospital procedural volumes were associated with lower mortality.

Changing Patterns of Lung Cancer Mortality in Andalusia: Insights From Age-period-cohort Analysis and Historical Smoking Trends

IntroductionLung cancer remains one of the leading causes of cancer death worldwide. This study examines lung cancer mortality trends in Andalusia, Spain, from 2003 to 2022, focusing on gender differences and the influence of age, period and cohort effects. Material and methodsThis longitudinal ecological study analyzed lung cancer mortality data in Andalusia from 2003 to 2022, using age-period-cohort (A-P-C) and joinpoint regression models. Mortality rates were calculated by sex, age group, and standardized to the 2013 European Standard Population. ResultsBetween 2003 and 2022, Andalusia recorded 68,480 lung cancer deaths, with a significant gender disparity. Male mortality decreased (−1.9%), while female mortality increased (3.5%). Joinpoint analysis revealed a notable rise in female mortality rates after 2015. Age-specific analyses showed decreasing rates for men across all age groups, with a sharper decline for younger men. Women experienced increasing rates, particularly among those aged 35–64. The A-P-C model identified significant cohort effects, with decreasing rate ratios for men and increasing ones for women, reflecting historical smoking patterns. ConclusionsLung cancer mortality in Andalusia has exhibited a stark gender divide, reflecting the region's historical smoking patterns. While declining rates among men and younger women indicate the efficacy of tobacco control measures, the persistent rise in female mortality underscores the enduring effects of past smoking habits. These findings emphasize the imperative for ongoing public health initiatives and gender-specific interventions to mitigate the burden of lung cancer in Andalusia.

Trends in cancer mortality under age 50 in 15 upper-Middle and high-income countries.

Rising cancer incidence, particularly for colorectal cancer, has been reported in young adults. This study examined whether this is related to an increase in mortality. We analysed World Health Organization (WHO) mortality data among young adults aged 25-49 in 15 most populous upper-middle and high-income countries from 1990 to 2021 with reliable data. Mid-year populations were retrieved from the United Nations for the American Countries and from the WHO for the other countries. We compared age-standardised mortality rates (ASMRs) in 2019-2021 to 2009-2011 and performed joinpoint regression analysis for all cancers and selected most common cancer sites: colorectum, pancreas, lung and breast. In 2019-2021, the highest ASMRs (per 100,000) were in Romanian males (38.6) and Argentinian females (45.9), while the lowest ones in Japan (males: 16.3; females: 22.7). ASMRs for colorectal cancers increased in 2019-2021 compared to 2009-2011 in nine countries among men and in seven countries among women. The highest increases were in the UK (males: +26.1%; females: +33.7%), Canada (males: +25.3%), and Mexico (males: +33.5%; females: +29.7%). Long-term analysis over the last three decades showed declining trends in total cancer mortality in the majority of countries, in lung cancer mortality across all countries, and in breast cancer in all countries except in Latin America. While mortality from common cancers has generally decreased over the past three decades, mortality from colorectal cancer has increased in some countries. This highlights the need to control the obesity epidemic and implement targeted surveillance strategies in young populations.

Trends in incidence, mortality, and survival of cutaneous malignant melanoma over three decades: a population-based study in Southern Spain.

Cutaneous malignant melanoma (CMM) represents a global public health problem. Epidemiological studies about CMM trends tend to focus on single indicators or lack information about tumor characteristics that can help gain a more thorough understanding of CMM epidemiology. To fill this gap, we studied CMM trends in incidence, mortality, and survival over three decades and considering sex, age, and tumor characteristics. Data were obtained for all new cases of CMM diagnosed 1985-2017 from the population-based cancer registry in Granada (Southern Spain) and for deaths due to CMM by the Ministry of Health of the Spanish government. Incidence, mortality, and survival estimates were obtained according to sex, age group, anatomical site, histological type, Breslow index, and Clark level. Observed and net survival were calculated for 1, 3, and 5 years using the Kaplan-Meier and Pohar-Perme methods, respectively. Log-linear jointpoint regression was used to assess temporal trends in age-standardized rates of incidence and mortality. Between 1985-2017, 2,446 patients aged 15 years and older were newly diagnosed with CMM. There was a significant increase in incidence, both in men and women (APC 4.4% and 3.7% respectively), mainly in superficial spreading and nodular melanomas, and more pronounced among those with <1mm Breslow index. Mortality rates increased, mainly driven by increases among men and individuals ≥65 years old. Nodular melanoma had the worst prognosis, with a 5-year observed survival of 67.1% compared to survival greater than 90% for the other subtypes. 5-year net survival improved from 78.3% in 1985-1997 to 88.6% in 2008-2017, with a clear trend by Breslow index. The incidence of melanoma in early stages in Southern Spain has increased over the past decades. This has been accompanied by noticeable improvements in mortality and survival, especially among younger age groups, suggesting the potential effectiveness of prevention strategies, and new treatment regimens.

Decomposition of Heart Failure Prevalence and Mortality Among Older Adults in the United States: Medicare-Based Partitioning Analysis.

Heart failure (HF) is a challenging clinical and public health problem characterized by high prevalence and mortality among US older adults, along with a recent decline in HF prevalence and increase in mortality. The changes of prevalence can be decomposed into pre-existing disease prevalence, disease incidence, and respective survival, while the changes of mortality can be decomposed into mortality in the general population independent from HF, pre-existing HF prevalence, incidence, and respective survival. These epidemiological components may contribute differently to the changes in prevalence and mortality. We aimed to investigate and compare the relative contributions of epidemiologic determinants in HF prevalence and mortality trends. This study was a secondary data analysis of 5% of Medicare claims data for 1992-2017 in the United States. Medicare is a federal health insurance program for older adults aged 65+ years as well as people with specific disabilities and end-stage renal disease. Age-adjusted prevalence and incidence-based mortality (IBM; all-cause mortality that occurred in patients with HF) were partitioned into their respective epidemiologic determinants using the partitioning analysis approach. The age-adjusted HF prevalence (1/100 person-years) increased from 11 in 1994 to 14.6 in 2005, followed by a decline to 12.6 in 2017, and the age-adjusted HF IBM (1/100,000) increased from 2220.8 in 1994 to 2563.7 in 2000, then declined to 2075.9 in 2016, followed by an increase to 2094.7 in 2017. The HF incidence (1/1000 person-years) declined from 29.4 in 1992 to 19.9 in 2017. The 1-, 3-, and 5-year survival trend showed declines in recent years. Partitioning of HF prevalence showed three phases: (1) decelerated increasing prevalence (1994-2006), (2) accelerated declining prevalence (2007-2014), and (3) decelerated declining prevalence (2015-2017). During the whole period, the decreasing HF incidence contributed to the declines in prevalence, overpowering prevalence increases contributed from survival. Likewise, partitioning of HF IBM showed three phases: (1) decelerated increasing mortality (1994-2001), (2) accelerated declining mortality (2002-2012), and (3) decelerated declining mortality (2013-2017). The decreasing HF incidence in 1994-2017 and increasing survival in 2002-2006 contributed to the declines in mortality, while the decreasing survival in 2007-2017 contributed to the mortality increase. Decade-long declines in HF prevalence and mortality mainly reflected decreasing incidence, while the most recent increase of mortality was predominantly due to the declining survival. If current trends persist, HF prevalence and mortality are forecasted to grow substantially in the next decade. Prevention strategies should continue the prevention of HF risk factors as well as improvement of treatment and management of HF after diagnosis.