ArticleBrain and behavior2026
Trends and Disparities in Aspiration Pneumonitis Mortality With Co-Listed Stroke Among US Adults, 1999-2024: A CDC WONDER Analysis.
Article in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAspiration pneumonitis is a serious poststroke respiratory complication, yet contemporary US mortality trends involving aspiration pneumonitis as the underlying cause of death with co-listed stroke remain unclear. We evaluated national trends and disparities in aspiration pneumonitis mortality with co-listed stroke among US adults aged ≥ 25 years from 1999 to 2024.
methodsWe conducted a retrospective, population-based serial cross-sectional analysis of CDC WONDER multiple cause of death data from 1999 through 2024. Deaths were included when aspiration pneumonitis (ICD-10 J69.0) was the underlying cause and stroke (I60-I69) was a contributing cause among adults aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) per 100,000 population were standardized to the 2000 US population; age-specific rates were crude. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs).
resultsA total of 296,691 deaths were identified. The overall AAMR declined from 9.20 in 1999 to 3.55 in 2024 (AAPC, -3.66%; 95% CI, -4.34 to -2.97, p < 0.001). Mortality declined among men from 13.38 to 4.92 (AAPC, -3.85%) and women from 6.79 to 2.46 (AAPC, -3.92%; both p < 0.001). Mortality declined across all census regions, including Northeast (AAPC, -3.98%; p < 0.001), Midwest (AAPC, -3.76%; p < 0.001), South (AAPC, -3.93%; p < 0.001), and West (AAPC, -3.57%; p < 0.001), with the South having the higher AAMR (3.88) in 2024. Mortality remained higher in nonmetropolitan counties, with AAMR declining from 9.96 in 1999 to 4.42 in 2020 (AAPC, -4.05%; p < 0.001), compared with metropolitan counties, where the AAMR declined from 9.02 to 3.80 (AAPC, -4.31%; p < 0.001). Among non-Hispanic Black adults, the 2014-2024 trend was stable (APC, 1.13%; p = 0.12). Rates increased after 2010 among adults aged 35-44 years (APC, 6.65%; p < 0.001), 45-54 years (APC, 4.70%; p < 0.001), and 55-64 years (APC, 3.96%; p < 0.001).
conclusionAspiration pneumonitis mortality with co-listed stroke declined nationally, but progress was uneven, with persistent demographic, regional, and rural disparities.
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