Twenty seven year trends in stroke and urinary tract infection related mortality in the United States.

BACKGROUND

Stroke continues to be a prevalent cause of morbidity and mortality within the United States. On top of that, UTIs continue to be a prevalent complication, which leads to adverse outcomes. Nonetheless, national temporal trends in deaths associated with both stroke and UTIs have not been well understood.

METHODS

In this research, a population based observational study was done utilizing the CDC WONDER database for the period between 1999 and 2025. Adult patients with ≥55 years with stroke (ICD-10: I60-I64) and UTI (N39.0) in death certificate were selected. The annual age-adjusted mortality rate (AAMR) per 100,000 population was done through Joinpoint regression analysis to find the APC. A sensitivity analysis limited the stroke group to stroke alone and UTI a contributing factor.

RESULTS

From 1999-2025, 84,445 stroke- and UTI-related deaths occurred among older U.S. adults. Overall AAMR was 4.3 per 100,000 (95% CI, 4.2-4.5), declining from 7.5 to 2.8 between 1999 and 2019 (APC, -5.95%, p < 0.000001; -2.78%, p = 0.0104), rising nonsignificantly through 2022 (APC, 5.93%, p = 0.0868), then declining non significantly through 2025 (APC, -4.27%, p = 0.08). AAMR was higher in women (4.8) than men (4.0), both declining significantly (p < 0.000001) with a significant post-2019 rise in women only (APC, 6.30%, p = 0.0052). By race, AAMR was highest in non-Hispanic Black individuals (7.0) and lowest in Asian/Pacific Islanders (3.3), with significant declines across all groups (p < 0.05) and a significant post-2019 rebound among Black individuals (APC, 10.01%, p = 0.042). AAMR was highest in the South (5.2) and lowest in the Northeast (3.5), with significant early declines region-wide (p < 0.05) and significant post-2019 rebounds in the South, West, and Northeast (p < 0.05). Nonmetropolitan AAMR (5.1) exceeded metropolitan AAMR (4.3), with significant declines in both (p < 0.00001)

CONCLUSIONS

Although mortality from stroke and UTI has decreased over time, significant racial, sex, and regional disparities persist.