This study aims to study the demographic trends in status epilepticus-related mortality in older adults (≥65) in the United States from 1999 to 2020.

Status epilepticus (SE) is a neurological emergency characterized by prolonged or recurrent seizures, often associated with significant morbidity and mortality. Despite advances in treatment, SE-related mortality remains high, particularly in older patients with underlying health conditions.

Death certificate data from the CDC WONDER database was analyzed using the Multiple-cause of death MCD-ICD 10 codes (G41.0-G41.2, G41.8, G41.9) for patients ≥ 65 years. Age-adjusted mortality rates (AAMRs) per 100,000 and Annual percentage changes (APCs) along with 95% CIs were calculated using the Joinpoint Regression Program and stratified by age, gender, race/ethnicity, census region, and state.

There were 17,883 SE-related deaths in older adults from 1999-2020. The AAMR declined from 1.5 in 1999 to 1.2 in 2005 (APC= -4.56, 95 %CI: -8.05, -0.94) after which it inclined to 3.3 in 2020 (APC=7.72, 95% CI: 7.04, 8.41). Women had a consistently higher AAMR than men from 1999 (AAMR women:1.5 vs men:1.4) to 2020 (AAMR women: 3.4 vs men: 3). Non-Hispanic (NH) black had the highest AAMR (5.1), followed by NH Indian or Alaska Native (2.9), NH white (1.9) and Hispanics or Latinos (1.8). Mortality also varied substantially by Census region with the highest AAMR in the south region (2.2), and state with the District of Columbia having the highest (4.2) and Nebraska having the lowest (1.0) AAMRs. According to the place of death medical facilities observed the highest percentage (83.8%).

SE-related mortality increased from 1999-2020. Substantial gender and racial disparities were also observed with women exhibiting a consistently higher mortality than men and NH blacks having the highest mortality. Further studies and targeted interventions are required to address these disparities.