To evaluate mortality trends for traumatic subdural hemorrhage (SDH) in the United States (US) from 1999 to 2020.

Traumatic SDH is a critical and often fatal condition, commonly resulting from head injuries. While improvements in trauma care have been made, understanding the long-term trends in mortality is essential for targeting high-risk populations and enhancing prevention strategies.

We analyzed the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research(CDC WONDER) for death certificates (1999-2020) of adults 45 years and older, with traumatic SDH using ICD-10 code S06.5. Age-adjusted mortality rates (AAMR) per 100,000 and annual percent change (APC) with a 95% confidence interval (CI) were calculated through joint-point regression analysis and trends were analyzed across gender, year, race, region, and state.

Between 1999 and 2020, a total of 149,042 deaths were attributed to traumatic SDH. The AAMR increased from 5.6 in 1999 to 6.4 in 2020, with a significant rise from 2006 to 2018 (APC: 1.88*; 95% CI= 0.36-2.52), followed by a slight insignificant decrease in AAMR from 2018 to 2020 (APC: -0.58; 95% CI= -2.16-1.62). Males had almost double the AAMR than females (8.1 vs 4.3). Among racial groups, non-Hispanic (NH) American Indians had the highest AAMR (6.7), followed by NH Whites (6.0) and NH Asians (5.6). Geographically, the West region recorded the highest AAMR (6.3), while the Northeast had the lowest (4.7). Washington had the highest state-level AAMR (10.9), whereas New Jersey had the lowest (2.9).

This analysis of CDC WONDER data highlights increasing mortality rates due to traumatic SDH in the U.S., particularly among males and NH American Indians. Regional disparities also suggest a need for targeted interventions to address these trends. Further research may help elucidate the causes behind these variations and guide public health efforts to reduce mortality.