This study aims to investigate the status epilepticus-related mortality trends and disparities over the past 25 years in the United States.

Status epilepticus (SE) is a life-threatening neurological emergency and a major cause of epilepsy-related mortality in the United States (US). Given the limited data available, this study aims to explore the contemporary SE-related mortality trends in the US.

The Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) mortality database was used to access and analyze the mortality data from 1999 to 2024. The age-adjusted mortality rates (AAMR) per 100,000 population were calculated. SE was identified using the ICD-10 code G41. Those deaths were included in the analysis where SE was either the underlying or contributing cause of death. Trends were analyzed by year, sex, and census region. Joinpoint regression was used to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Weighted average APCs were calculated and reported as AAPCs with 95% CIs to summarize mortality trends over the study period.

From 1999 to 2024, a total of 48,750 deaths occurred where SE could be listed as either the underlying or contributing cause, with an overall average AAMR of 0.53/100,000. The overall AAMR increased from 0.36 in 1999 to 0.84 in 2024 (AAPC: 3.32; p < 0.001). Both men (0.53) and women (0.52) had comparable average AAMRs. But, both men (AAPC: 3.15; p < 0.001) and women (AAPC: 3.40; p = 0.003) showed a significantly increasing trend in AAMRs throughout the study period. By region, the South region (0.58) had the highest average AAMR compared to others.

The mortality associated with SE has almost doubled over the study period, highlighting the need for further investigation and targeted interventions to address these concerning trends.