Abstract HUP13: Trends and Disparities in Pediatric Stroke Mortality in the United States: An Analysis of CDC WONDER Data

Background: Pediatric stroke is a significant cause of childhood morbidity and mortality. Understanding long-term mortality trends and identifying demographic or regional disparities is crucial for public health planning and resource allocation. This study aimed to analyze trends in pediatric stroke mortality in the U.S. from 1999 to 2020, focusing on variations by sex and geographic region. Methods: We conducted a retrospective analysis of pediatric (age > 18 years) stroke (ICD-10 codes I60.0 to I69.0) mortality data using the Centers for Disease Control and Prevention (CDC) WONDER database for the years 1999-2020. We extracted the total deaths, crude mortality rates per 100,000 population, and then the data were stratified and analyzed by sex, race, and U.S. Census Region to identify significant trends and disparities. Results: A total of 6,286 pediatric stroke deaths were recorded from 1999 to 2020, corresponding to an overall crude mortality rate of 0.4 per 100,000 population. The overall crude mortality rate was 0.4 per 100,000 for both groups. However, significant regional disparities in mortality were identified. The South recorded the highest number of deaths at 2,610, with a crude rate of 0.4 per 100,000. The Midwest had the second-highest mortality, with 1,437 deaths and a crude rate of 0.4. However, the Northeast (949 deaths) and the West (1,290 deaths) demonstrated lower crude mortality rates of 0.3 per 100,000. In terms of racial disparities, Black or African American children experienced the highest burden of mortality, with 3,448 deaths and a crude rate of 0.64 per 100,000, higher than the crude rates for White children (8,422 deaths, crude rate of 0.34 per 100,000), Asian or Pacific Islander children (466 deaths, crude rate of 0.27 per 100,000), and American Indian or Alaska Native children (91 deaths, crude rate of 0.16 per 100,000). Conclusion: Over the last two decades, pediatric stroke mortality rates have remained relatively stable but show clear and persistent disparities based on sex, U.S. Census Region, and race. The higher mortality burden observed in males and the Southern and Midwestern regions, as well as in Black or African American children, highlights the need for further investigation into underlying causes, such as differences in risk factor prevalence, healthcare access, and reporting practices. These findings can inform targeted public health strategies and research efforts aimed at mitigating these disparities.