ABSTRACT NUMBER: ESOC2026A494 DEMOGRAPHIC AND REGIONAL MORTALITY TRENDS OF ASPIRATION PNEUMONIA AMONG OLDER ADULTS WITH ISCHEMIC STROKE IN THE US (1999-2020)

Abstract Background and aims Aspiration pneumonia is a major cause of mortality in older patients with ischemic stroke. This study aims to identify its regional and demographic mortality trends among older adults with ischemic stroke in the United States. Methods Age-adjusted mortality rates (AAMRs) were extracted from the CDC WONDER database using ICD-10 codes I63 (for ischemic stroke) and J69.0 (for aspiration pneumonia) from 1999 to 2020 in adults ≥65 years of age. These AAMRs were stratified by gender, ethnicity, and demographics and analyzed using Joinpoint regression to determine annual percent changes (APCs). Results Between 1999 and 2020, 18,311 deaths were reported. The analysis shows that AAMR declined from 5 in 1999 to 3.7 in 2003 (APC: -7.2), after which it significantly decreased to 1 in 2009 (APC: -23.4), but increased to 2.1 in 2020 (APC: 10.6). Men consistently had a higher overall AAMR (2.7) compared to women (1.5). Racially, the highest overall AAMR was reported in Non-Hispanic (NH) African Americans (2.3), followed by NH Whites (2) and NH American Indians (2), NH Asians (1.6), and Hispanics (1.5). States such as Washington and Vermont reported higher overall AAMRs compared to other states. The regional analysis showed higher overall AAMR in the South region (2.3), followed by the West (2), the Midwest (1.9), and the Northeast (1.5), and higher AAMR in nonmetropolitan areas (2.2) compared to metropolitan areas (2). Conclusions The mortality trends show significant disparities, with rising mortality in the 2nd decade of study period. Further research is essential to plan appropriate interventions in vulnerable populations. Conflict of interest Umar Maqbool: nothing to disclose , Ahsan Qadeer: nothing to disclose , Rayyan Masood: nothing to disclose , Iqra Alamgir: nothing to disclose , Muhammad Saad: nothing to disclose , Muhammad Fayzan Mehmood: nothing to disclose , Unsa Alamgir: nothing to disclose , Eman Alamgir: Nothing to disclose, Muaz Loon: Nothing to disclose, Abdullah Maqbool: nothing to disclose, Hamsaraj Shetty: Nothing to disclose