Evolving Epidemiology of Increasing Trauma Deaths in the United States (2000-2020)

Abstract

Objective: To utilize the US consus data available every 10 years to show the trauma death rates and how it has changed over 20 years.

Background: Over the past 2 decades, the epidemiology of trauma has shifted significantly, driven primarily by demographic changes. The aim of our study was to illustrate the changing landscape of trauma mortality rates and compare them with other leading causes of death.

Methods: We performed a cross-sectional study from 2000 to 2020, using data from the Centers for Disease Control and Prevention and Web-based Injury Statistics Query and Reporting System. Trauma deaths were defined according to the World Health Organization classification, encompassing unintentional injuries, homicides, and suicides. Mortality rates were calculated per 100,000 using U.S. census data.

Results: The analysis revealed a 91% increase in trauma mortality from 2000 to 2020, rising to 268,926 deaths-far surpassing the 17.8% population growth. A trimodal distribution of trauma deaths persisted, with age peaks shifting to 30 to 35, 55 to 59, and above 70 years by 2020. Causes of death shifted with increases in firearm, poisoning, and fall, while motor vehicle mortality rates declined. By 2020, trauma was the leading cause of death up to age 50. Trauma remained the leading cause of cumulative deaths up to age 67 and the primary contributor to years of life lost. Death rates from cancer and heart disease showed a declining trend.

Conclusions: Trauma has become the leading cause of death up to age 50 and remains a primary contributor to years of life lost. The largest increase in trauma deaths was noted among baby boomers and millennials. As death rates from cancer and heart disease decline, it is essential to reprioritize and reallocate resources to address the evolving trauma epidemiology in an aging and expanding U.S. population.

Level of evidence: Level III-retrospective study.

Keywords: CDC; US census; cancer; deaths; epidemiology; heart disease; mortality; mortality rate; trauma.