Trends in mortality and comorbidity of multiple myeloma among u.S. adults with stroke: A CDC wonder-based analysis, 1999–2023

Abstract Background : Multiple Myeloma, a malignancy of the plasma cells remains one of the reasons for widespread morbidity and mortality. Multiple Myeloma and Stroke share several risk factors like age, hypercoagulability and renal dysfunction causing them to influence each other's effects. This makes it crucial to analyse the intersection between the two conditions in order to improve survival rates. This study assesses the trends in mortality in patients with Multiple Myeloma and Stroke in the United States from 1999-2023. Methods : We analyzed death certificates of adults aged>25' from the CDC-WONDER database with Multiple Myeloma (ICD-10 codes: C90) and Stroke(ICD-10 codes: I63) from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, year and age. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality trends, along with 95% confidence intervals (CIs). Results: Multiple Myeloma and Stroke caused 11,719 deaths in patients aged>25 years during our study period from 1999 to 2023. There was an overall decrease in mortality with a change in AAMR from 0.28 in 1999 to 0.22 in 2023 (AAPC: -1.03; 95% CI: -2.01 to -0.04). Demographically, the death rates for males decreased with a change in AAMR from 0.32 to 0.29 (AAPC: -0.21; 95% CI: -1.28 to 0.87) and an overall AAMR of 0.25. Females however had a lower mortality rate as compared to males with an overall AAMR of 0.17 and a change in AAMR from 0.25 to 0.18(AAPC: -1.72; 95% CI: -3.03 to -0.40). In terms of race, mortality decreased among the Non-Hispanic (NH) Black or African Americans from 0.75 to 0.55(AAPC: -1.05; 95% CI: -2.27 to 0.18) while those among the white community decreased from 0.24 to 0.17(AAPC: -1.24; 95% CI: -2.40 to -0.06). Geographically, regions in the South,West and Midwest showed the highest overall AAMR of (0.22) followed by the Northeast with an AAMR of (0.17). Metropolitan and Non metropolitan zones had almost the same mortality rates with a slight increase in the AAMR of Non metropolitan areas (0.22) as compared to Metropolitan areas (0.21). When stratified according to states, AAMRs varied highly from the highest in North Dakota and Nebraska to the lowest in Nevada. Conclusion: The overall mortality rates for Multiple Myeloma and Stroke decreased between the years 1999-2023. The highest AAMR was seen in males, regions in the South, West and Midwest, with the greatest change racially in NH Blacks and the Non metropolitan areas.