Journal of the National Medical Association · 2026
Trends in inflammatory diseases of nervous system-related mortality among adults in the United States from 1999-2023; comparing pre-2018 and post-2018 era disparities.
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Kumar Dinesh, Kalpina Fnu, Saif Inza, Shujaat Tabia, Rizvi Syed Muhammad Asjad, Mohsin Muhammad Saad, Kumar Sumet, Teena Fnu, Javeid Javeria, Inam Syed Hashim Ali, Ferguson Paul
Аннотация
BACKGROUND: Inflammatory diseases of the nervous system, though uncommon, cause substantial mortality; yet their long-term trends in the U.S. remain underexplored. This study aims to evaluate mortality trends and patterns of inflammatory diseases of the nervous system in the US from 1999 to 2023, comparing patterns before and after 2018.
METHODS: We used the CDC WONDER database to extract age-adjusted mortality rates (AAMRs) per 100,000 adults for inflammatory diseases of nervous system (G00-G09) mortality in the US adults (>25 years) from 1999 to 2023, with the study period divided into two eras (ie, pre- and post-2018). Joinpoint regression was used to evaluate average annual percent change (AAPCs) and their confidence intervals (CIs).
RESULTS: From 1999 to 2023, inflammatory diseases of the nervous system caused 71,894 deaths with a decreasing trend [AAPC: -0.31; p-value <0.001]. The AAMR was higher in the post-2017 era (1.36) than in the pre-2017 era (1.29). Overall, the trend declined in pre-2017 era [AAPC: -1.68; p-value <0.001] than in post-2017 era [AAPC: 4.19; p-value= 0.002]. In both eras, males (1.56 vs 1.67) demonstrated higher AAMRs than females (1.09 vs 1.11). The incline in mortality was significantly greater in females (AAPC: -1.96%; p-value <0.001 vs 5.01%, p-value <0.001) than in males (AAPC: -1.65%; p-value <0.001 vs 4.14%; p-value = 0.05) in both the eras. A similar trend was observed across racial/ethnic groups, except for NH Blacks (AAMRs: 2.0 vs 1.78) and NH Asians (AAMRs: 0.84 vs 0.81) who showed greater mortality rates in the pre-2017 era. NH American Indians (AIs) showed the highest incline in mortality burden between pre-2018 and post-2018 (AAPC: 1.01%; p-value = 0.18 vs 8.46%; p-value = 0.002).
CONCLUSION: Overall inflammatory diseases of the nervous system in US adults declined from 1999 to 2023 but increased markedly after 2017. Males showed consistently higher mortality than females. Except for NH AI patients, other racial/ethnic groups show smaller inclined in mortality post-2018.
METHODS: We used the CDC WONDER database to extract age-adjusted mortality rates (AAMRs) per 100,000 adults for inflammatory diseases of nervous system (G00-G09) mortality in the US adults (>25 years) from 1999 to 2023, with the study period divided into two eras (ie, pre- and post-2018). Joinpoint regression was used to evaluate average annual percent change (AAPCs) and their confidence intervals (CIs).
RESULTS: From 1999 to 2023, inflammatory diseases of the nervous system caused 71,894 deaths with a decreasing trend [AAPC: -0.31; p-value <0.001]. The AAMR was higher in the post-2017 era (1.36) than in the pre-2017 era (1.29). Overall, the trend declined in pre-2017 era [AAPC: -1.68; p-value <0.001] than in post-2017 era [AAPC: 4.19; p-value= 0.002]. In both eras, males (1.56 vs 1.67) demonstrated higher AAMRs than females (1.09 vs 1.11). The incline in mortality was significantly greater in females (AAPC: -1.96%; p-value <0.001 vs 5.01%, p-value <0.001) than in males (AAPC: -1.65%; p-value <0.001 vs 4.14%; p-value = 0.05) in both the eras. A similar trend was observed across racial/ethnic groups, except for NH Blacks (AAMRs: 2.0 vs 1.78) and NH Asians (AAMRs: 0.84 vs 0.81) who showed greater mortality rates in the pre-2017 era. NH American Indians (AIs) showed the highest incline in mortality burden between pre-2018 and post-2018 (AAPC: 1.01%; p-value = 0.18 vs 8.46%; p-value = 0.002).
CONCLUSION: Overall inflammatory diseases of the nervous system in US adults declined from 1999 to 2023 but increased markedly after 2017. Males showed consistently higher mortality than females. Except for NH AI patients, other racial/ethnic groups show smaller inclined in mortality post-2018.