Abstract 4371827: Geographic and Racial Disparities in Stroke-Related Mortality from Infective Endocarditis Among Young Adults (1999–2023): A CDC WONDER Analysis

Introduction: Stroke is a common complication of infective endocarditis (IE). Previous studies have explored trends in IE-related mortality; however, trends in IE and stroke-related mortality are not well understood. Therefore, we aim to explore racial and geographic disparities in stroke-related mortality in IE in young adults during the past two decades. Methods: We used the CDC WONDER database to access age-adjusted mortality rates (AAMR) per 100,000 people from 1999 to 2023 among patients aged 15-64 years. Joinpoint regression software was used to estimate the annual percentage change (APC) along with 95% confidence intervals (CI), in order to evaluate significant trends in the change of AAMR over time. ICD-10 codes used were I60–I64, B37.6, I33.0, I33.9, and I38. Results: The total number of deaths due to stroke-related mortality in IE patients was 14,842. The AAMRs remained stable from 1999 to 2011 (APC: -0.53; 95% CI: -7.08 to 1.53) and showed a significant increasing trend from 2011 to 2023 (APC: 4.91; 95% CI: -3.23 to 11.00). Men had more deaths compared to women (11971 vs 5004). However, AAMRs have continued to rise significantly among women from 2008 to 2023 (APC: 4.14; 95% CI: 2.11 to 14.96), whereas rates have remained stable among men in recent years (2021–2023). APC: -9.13; 95% CI: -18.77 to 4.02). NH Black had higher AAMR; however, the APC continued to increase significantly for NH Black, Hispanic, and NH White patients (APC 5.30, 8.02, and 7.35, respectively) in recent years. The District of Columbia, followed by West Virginia and Kentucky, had the highest overall AAMR. The majority of deaths occurred in inpatient medical facilities (70.3%), the South census region (43%), and the 55–64 year age group (43%). Conclusion: AAMR of stroke-related mortality in IE patients continues to rise at an alarming rate. Further studies and nationwide policies are needed to reduce mortality among younger adults.