Clinical neurology and neurosurgery · 2025
Changing mortality trends in encephalitis, myelitis, and encephalomyelitis in the United States: A Population-based analysis from 1999 to 2020.
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Alrabadi Bassel, Marouf Mahmoud, Bandak Natalie, Refai Yamen, Alhassan Leen, Alghzawi Yousef, Obeidat Ahmed Z
Аннотация
OBJECTIVE: Encephalitis, myelitis, and encephalomyelitis are serious neuroinflammatory disorders with considerable mortality. This study aims to analyze U.S. mortality trends for these conditions from 1999 to 2020, examining variations across demographic groups, geography, and urbanization levels to identify evolving patterns and risk factors.
METHODS: A retrospective, population-based study used CDC WONDER mortality data. Deaths attributed to encephalitis, myelitis, and encephalomyelitis were identified using ICD-10 code G04. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 individuals. Trends were analyzed by age, gender, race/ethnicity, geography, and urbanization. Annual percentage change (APC) and average annual percentage change (AAPC) were estimated using Joinpoint regression.
RESULTS: From 1999-2020, 17,325 deaths were recorded. AAMR declined until 2011 (APC: -2.38 %, p < 0.05) but increased from 2011 to 2020 (APC: 3.04 %, p < 0.05). Older adults (≥65 years) had the highest mortality (AAMR: 0.77-1.31). Males showed a sharp increase from 2018 to 2020 (APC: 13.23 %, p < 0.05), while females had an overall decline (AAPC: -0.61). Mortality increased in non-Hispanic Whites (AAPC: 0.53, p = 0.0488) and Black or African Americans after an initial decline (AAPC: -1.41, p = 0.0172). Rural areas had consistently higher mortality than urban areas, significantly increasing from 2010 to 2020 (APC: 3.61 %, p < 0.05).
CONCLUSION: After a prolonged period of decline, mortality from encephalitis, myelitis, and encephalomyelitis in the U.S. has increased since 2011, particularly among older adults, males, and rural populations. These trends suggest evolving demographic and geographic risk factors warranting further investigation to improve targeted public health interventions and clinical management.
METHODS: A retrospective, population-based study used CDC WONDER mortality data. Deaths attributed to encephalitis, myelitis, and encephalomyelitis were identified using ICD-10 code G04. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 individuals. Trends were analyzed by age, gender, race/ethnicity, geography, and urbanization. Annual percentage change (APC) and average annual percentage change (AAPC) were estimated using Joinpoint regression.
RESULTS: From 1999-2020, 17,325 deaths were recorded. AAMR declined until 2011 (APC: -2.38 %, p < 0.05) but increased from 2011 to 2020 (APC: 3.04 %, p < 0.05). Older adults (≥65 years) had the highest mortality (AAMR: 0.77-1.31). Males showed a sharp increase from 2018 to 2020 (APC: 13.23 %, p < 0.05), while females had an overall decline (AAPC: -0.61). Mortality increased in non-Hispanic Whites (AAPC: 0.53, p = 0.0488) and Black or African Americans after an initial decline (AAPC: -1.41, p = 0.0172). Rural areas had consistently higher mortality than urban areas, significantly increasing from 2010 to 2020 (APC: 3.61 %, p < 0.05).
CONCLUSION: After a prolonged period of decline, mortality from encephalitis, myelitis, and encephalomyelitis in the U.S. has increased since 2011, particularly among older adults, males, and rural populations. These trends suggest evolving demographic and geographic risk factors warranting further investigation to improve targeted public health interventions and clinical management.