Deans' stroke musings: US Trends From 1999 to 2020: Mortality and Location of Deaths in Ischemic Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, June 7, 2025

US Trends From 1999 to 2020: Mortality and Location of Deaths in Ischemic Stroke

With some actual stroke leadership deaths could be vastly reduced by just stopping the 5 causes of the neuronal cascade of death in the first week saving hundreds of million to billions of neurons! AND YOU DON'T KNOW THAT? My God, the complete incompetence out there!)

US Trends From 1999 to 2020: Mortality and Location of Deaths in Ischemic Stroke

Ischemic stroke deaths at home nearly quadrupled from 8.44% in 1999 to 29.31% in 2020, while inpatient deaths dropped from 46.41% to 29.56%.

Patterns of ischemic stroke mortality have varied over the last 2 decades in the United States, according to study findings published in PLOS One.

Stroke is one of the leading causes of mortality in the US. Researchers studied the trends in location of ischemic stroke deaths to improve end-of-life care and address health care inequities.

The Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to examine trends in ischemic stroke mortality between 1999 and 2020.

Data from residents in the US who died from ischemic stroke, defined by the International Classification of Diseases, Tenth Revision (ICD-10), were identified for the analysis. Information of deceased individuals was further classified based on sex, race, age, and urbanization level. Location of death was categorized into medical, such as emergency rooms (ERs) and inpatient units, or nonmedical facilities, such as home and hospice facilities.

These findings highlight significant shifts in the patterns of mortality and location of death among ischemic stroke patients over the past two decades, with notable differences across urbanization levels and racial groups.

A total of 237,617 deaths related to ischemic stroke were recorded between 1999 and 2020. Overall, those in central metro areas (26.13%), White individuals (85.5%), women (58.3%), and those 85 years and older (41.5%) had the highest number of deaths.

The researchers observed that Asian/Pacific Islander individuals had the lowest age-adjusted death rates in 1999 that nearly doubled by 2020 (17.5 to 33.0 per 100,000, respectively). Black/African American individuals had the highest rates in 1999 that declined in 2006 and then increased in 2020 (87.6 to 34.8 to 87.8 per 100,000, respectively). White individuals had a gradual decline in rates in 1999 through 2020 (64.0 and 57.1 per 100,000, respectively).

Inpatient medical facilities were found to be the most common place of death, with 41.6% in large metro areas and 52.0% in nonmetro areas. Age-adjusted death rates were highest in medium metro areas (in all years between 1999 and 2020, except in 2010, 2012, 2013, and 2020). Deaths at home and hospice facilities were most common in urban areas, with large central metros reporting the highest percentages.

When assessing place of death by race, the researchers noted that American Indian/Alaska Native individuals had the highest percentage of deaths in medical facilities with inpatient services (54.72%); Asian/Pacific Islander individuals had the highest percentage of deaths at home (17.76%); and Black/African American individuals had the highest percentage of deaths at medical facilities with death on arrival and second-highest at hospice facilities (0.37% and 7.19%, respectively).

Distribution by place of death changed significantly from 1999 to 2020 — increased deaths at home (8.44% to 29.31%) and reduced deaths in medical facilities with inpatient services (46.41% to 29.56%).

“These findings highlight significant shifts in the patterns of mortality and location of death among ischemic stroke patients over the past [2] decades, with notable differences across urbanization levels and racial groups,” the researchers wrote. They concluded, “The increasing proportion of home deaths and persistent disparities in location of death suggest a need for further research to understand the underlying factors driving these trends and their implications for end-of-life care quality and access.”

One author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of author’s disclosures.

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