{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:44:11Z","timestamp":1792395851761,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Aspiration pneumonitis is a serious poststroke respiratory complication, yet contemporary US mortality trends involving aspiration pneumonitis as the underlying cause of death with co\u2010listed stroke remain unclear. We evaluated national trends and disparities in aspiration pneumonitis mortality with co\u2010listed stroke among US adults aged \u2265\u00a025 years from 1999 to 2024.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective, population\u2010based serial cross\u2010sectional analysis of CDC WONDER multiple cause of death data from 1999 through 2024. Deaths were included when aspiration pneumonitis (ICD\u201010 J69.0) was the underlying cause and stroke (I60\u2013I69) was a contributing cause among adults aged \u2265\u00a025 years. Age\u2010adjusted mortality rates (AAMRs) per 100,000 population were standardized to the 2000 US population; age\u2010specific rates were crude. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 296,691 deaths were identified. The overall AAMR declined from 9.20 in 1999 to 3.55 in 2024 (AAPC, \u22123.66%; 95% CI, \u22124.34 to \u22122.97,\n p<\/jats:italic>\n \u00a0<\u00a00.001). Mortality declined among men from 13.38 to 4.92 (AAPC, \u22123.85%) and women from 6.79 to 2.46 (AAPC, \u22123.92%; both\n p<\/jats:italic>\n \u00a0<\u00a00.001). Mortality declined across all census regions, including Northeast (AAPC, \u22123.98%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), Midwest (AAPC, \u22123.76%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), South (AAPC, \u22123.93%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), and West (AAPC, \u22123.57%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), with the South having the higher AAMR (3.88) in 2024. Mortality remained higher in nonmetropolitan counties, with AAMR declining from 9.96 in 1999 to 4.42 in 2020 (AAPC, \u22124.05%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), compared with metropolitan counties, where the AAMR declined from 9.02 to 3.80 (AAPC, \u22124.31%;\n p<\/jats:italic>\n \u00a0<\u00a00.001). Among non\u2010Hispanic Black adults, the 2014\u20132024 trend was stable (APC, 1.13%;\n p<\/jats:italic>\n \u00a0=\u00a00.12). Rates increased after 2010 among adults aged 35\u201344 years (APC, 6.65%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), 45\u201354 years (APC, 4.70%;\n p<\/jats:italic>\n \u00a0<\u00a00.001), and 55\u201364 years (APC, 3.96%;\n p<\/jats:italic>\n \u00a0<\u00a00.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Aspiration pneumonitis mortality with co\u2010listed stroke declined nationally, but progress was uneven, with persistent demographic, regional, and rural disparities.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/brb3.71739","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:21:51Z","timestamp":1789456911000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and Disparities in Aspiration Pneumonitis Mortality With Co\u2010Listed Stroke Among US Adults, 1999\u20132024: A CDC WONDER Analysis"],"prefix":"10.1002","volume":"16","author":[{"given":"Mirza Ammar","family":"Arshad","sequence":"first","affiliation":[{"name":"Department of Medicine Rahbar Medical and Dental College Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiza Talib","family":"Butt","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wahhaj","family":"Munir","sequence":"additional","affiliation":[{"name":"Department of Medicine Fatima Jinnah Hospital Bahawalpur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Hassan","family":"Daniyal","sequence":"additional","affiliation":[{"name":"Department of Medicine Rehman Medical Institute Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan Ahmad","family":"Daud","sequence":"additional","affiliation":[{"name":"Department of Medicine Al\u2010Aleem Medical College Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warda","family":"Ikram","sequence":"additional","affiliation":[{"name":"Department of Medicine Akhtar Saeed Medical and Dental College Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rijas","family":"Ramish","sequence":"additional","affiliation":[{"name":"Department of Medicine Al\u2010Aleem Medical College Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isbah","family":"Aman","sequence":"additional","affiliation":[{"name":"Department of Medicine Ziauddin Medical College Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Aslam","sequence":"additional","affiliation":[{"name":"Department of Medicine Quaid\u2010e\u2010Azam Medical College Bahawalpur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiz Ahmad","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Medicine Quaid\u2010e\u2010Azam Medical College Bahawalpur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4664-591X","authenticated-orcid":false,"given":"Asad Ali Ahmed","family":"Cheema","sequence":"additional","affiliation":[{"name":"Department of Medicine International School of Medicine International University Kyrgyzstan Bishkek Kyrgyzstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.032"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2026.1715043"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106485"},{"key":"e_1_2_14_5_1","first-page":"1","article-title":"Age Standardization of Death Rates: Implementation of the Year 2000 Standard","volume":"47","author":"Anderson R. N.","year":"1998","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010022\u201002960\u20105"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000534"},{"key":"e_1_2_14_8_1","unstructured":"Centers for Disease Control and Prevention.2024.National Center for Health Statistics. Underlying Cause of Death 1999\u20102020. CDC WONDER Online Database.https:\/\/wonder.cdc.gov\/ucd-icd10.html."},{"key":"e_1_2_14_9_1","unstructured":"Centers for Disease Control and Prevention.2024.Multiple Cause of Death 1999\u20132024.CDC WONDER.https:\/\/wonder.cdc.gov\/mcd.html."},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.834240"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.116.012890"},{"key":"e_1_2_14_12_1","doi-asserted-by":"crossref","unstructured":"Curtin S. C.2024.Stroke Death Rates among Adults Ages 45\u201364 by Region and Race and Hispanic Origin: United States 2002\u20132022. NCHS Data Brief No. 505.Centers for Disease Control and Prevention.https:\/\/doi.org\/10.15620\/cdc\/158326.","DOI":"10.15620\/cdc\/158326"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873211039721"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.124.040736"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40141\u2010013\u20100017\u2010y"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.119.024155"},{"key":"e_1_2_14_17_1","first-page":"1","article-title":"2013 NCHS Urban\u2010Rural Classification Scheme for Counties","volume":"2","author":"Ingram D. D.","year":"2014","journal-title":"Vital and Health Statistics"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2023.0056"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000437068.30550.cf"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.125.054423"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000190056.76543.eb"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101659"},{"key":"e_1_2_14_23_1","unstructured":"National Cancer Institute.2024. \u201cJoinpoint Regression Program v. 6.0.1.\u201d Statistical Methodology and Applications Branch Surveillance Research Program.National Cancer Institute."},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e31829734f2"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.120.018753"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.17245\/jdapm.2017.17.1.1"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.121.024785"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_14_29_1","volume-title":"International Statistical Classification of Diseases and Related Health Problems","author":"World Health Organization","year":"2016"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71739","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/brb3.71739","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:19:35Z","timestamp":1792394375000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.71739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/brb3.71739"],"URL":"https:\/\/doi.org\/10.1002\/brb3.71739","archive":["Portico"],"relation":{},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71739"}}