Trends in Cardiac Arrest Mortality Among Young Adults in the United States, 1999 to 2024

Q: What are the key findings of this study?

Cardiac arrest mortality among young adults in the US rose significantly between 2018 and 2021 with an annual percentage change of 16.50%, followed by a decline through 2024.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac arrest (n=289237). Intervention: Temporal trends (1999-2024). Primary outcome: Annual percentage change in age-adjusted mortality rate (2018-2021) (APC 16.50%, 95% CI 8.88-19.87, p=<0.001).

Q: What does this research mean for the field?

Cardiac arrest mortality among young adults in the United States experienced a significant rise between 2018 and 2021 before declining through 2024, with disproportionately higher rates observed in males, non-Hispanic Black individuals, and rural populations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate national trends in cardiac arrest-related mortality among young adults, with a focus on demographic and regional differences.

Aimen Shafiq; Mushood Ahmed; Eeshal Zulfiqar; Maryam Shahzad; Tallal Mushtaq Hashmi; Vivek Bhat; Stephen J. Greene; Robert J. Mentz; Marat Fudim; Jamal S. Rana; Gregg C. Fonarow; Ankur Kalra

doi:10.1016/j.jacadv.2026.102973

July 3, 2026JACC AdvancesOpen Access

Trends in Cardiac Arrest Mortality Among Young Adults in the United States, 1999 to 2024

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Key result

US young adult cardiac arrest mortality surged ~17% annually from 2018 to 2021 before declining.

APC 16.50%
95% CI 8.88-19.87
P<0.001
n=289,237

Figures

Graphical abstract published by JACC Advances — Graphical abstract · Published by JACC Advances · CC BY

Why the study?

Cardiac arrest affecting young individuals has emerged as a public health concern, prompting analysis of national mortality trends and demographic and regional disparities.

Key Points

To evaluate national trends in cardiac arrest-related mortality among young adults, with a focus on demographic and regional differences.
Extracted death certificate data from the CDC WONDER database for individuals aged 15 to 44 years between 1999 and 2024 (N = 289,237 cardiac arrest deaths).
Calculated age-adjusted mortality rates (AAMRs) per 100,000 individuals and estimated trends using JoinPoint regression analysis to calculate annual percent change (APC).
Overall AAMR remained stable from 1999 to 2018 (APC: −0.04% [95% CI: −0.62% to 0.42%]; P = 0.79), increased sharply from 9.13 in 2018 to 13.94 in 2021 (APC: 16.50% [95% CI: 8.88%-19.87%]; P < 0.001), and declined to 9.24 in 2024 (APC: −12.70% [95% CI: −17.90% to −9.18%]; P < 0.001).
Males consistently had higher AAMRs than females (11.06 vs 7.33), and non-Hispanic Black individuals experienced the highest average AAMR (18.68), compared with Hispanic or Latino (7.92), non-Hispanic White (7.81), and non-Hispanic other groups (6.00).
Geographic analysis revealed higher mortality in rural regions compared with urban areas (12.04 vs 8.30), with the Western region exhibiting the highest regional AAMR (10.47) in 2024.

Study Design

Type

Observational (n=289,237)

Structured PICO

P

Population

289,237 cardiac arrest-related deaths among young adults aged 15 to 44 years in the United States evaluated between 1999 and 2024.

O

Outcome

Age-adjusted mortality rates (AAMRs) per 100,000 individuals and annual percentage changes (APCs) for cardiac arrest-related deathshard clinical

Main Result

Effect estimate: APC 16.50% (95% CI 8.88-19.87)

p-value: p=<0.001

Cardiac arrest mortality among young adults in the US surged significantly between 2018 and 2021, with persistent disparities showing higher rates in males, non-Hispanic Black individuals, and rural populations.

Limitations

Reliance on ICD codes and death certificates may have introduced misclassification of the cause of death.
ICD-10 code I46 does not distinguish the underlying etiology and may include noncardiac causes like drug overdose or trauma.
Changes in coding practices and healthcare utilization during the COVID-19 pandemic may have contributed to fluctuations.
Lack of granular clinical characteristics such as vital signs, laboratory results, imaging, or genetic testing.
Absence of data on social determinants of health.
Inability to differentiate between out-of-hospital and in-hospital cardiac arrest.
Urban-rural classification data were only available through 2020.
Multiple stratified analyses increase the possibility of type I error.
Standardization to the 2000 U.S. population may not reflect the contemporary population structure.
Reliance on ICD codes and death certificates may have introduced misclassification of the cause of death
ICD-10 code I46 does not distinguish the underlying etiology of cardiac arrest
Lacks granular information on clinical characteristics (vital signs, labs, imaging, genetics) and social determinants of health
Cannot differentiate between out-of-hospital and in-hospital cardiac arrest
Urban-rural classification data only available through 2020, limiting extension of urbanization-specific analyses through 2024

Implication

The post-2018 mortality surge in young adults warrants clinical vigilance and disparity-focused screening; observational trends leave open causal drivers and prevention targets.

Abstract

BACKGROUND: Cardiac arrest (CA) affecting young individuals has been identified as a public health concern in the United States. OBJECTIVES: This study analyzes mortality trends associated with CA in young adults in the United States, focusing on demographic and regional disparities. METHODS: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was used to extract death certificate data for individuals aged 15 to 44 years from 1999 to 2024. Age-adjusted mortality rates (AAMRs) were determined, and annual percentage changes were generated using JoinPoint regression analysis. RESULTS: From 1999 to 2024, a total of 289,237 deaths were attributed to CA among young individuals in the United States. The AAMR remained stable from 1999 to 2018 but experienced a significant rise between 2018 to 2021, annual percentage change: 16.50% (95% CI: 8.88%-19.87%), followed by a decline through 2024. Males consistently exhibited higher AAMRs than females (11.06 vs 7.33). Among racial and ethnic groups, non-Hispanic (NH) Black or African American individuals had the highest average AAMR (18.68), followed by Hispanic/Latino populations (7.92), NH White individuals (7.81), and NH other populations (6.00). Geographically, the Western region had the highest AAMR (10.47) in 2024, whereas rural areas consistently recorded higher AAMRs than urban areas (12.04 vs 8.30). CONCLUSIONS: CA-related mortality in those aged 15 to 44 years exhibited fluctuating trends, with a notable rise between 2018 and 2021, followed by a decline through 2024. Males, NH Black Americans, and rural areas had higher mortality rates.

Discussion

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Cite This Study

Shafiq et al. (2026) conducted an observational in Cardiac arrest (n=289,237). Temporal trends (1999-2024) was evaluated on Annual percentage change in age-adjusted mortality rate (2018-2021) (APC 16.50%, 95% CI 8.88-19.87, p=<0.001). Cardiac arrest mortality among young adults in the US rose significantly between 2018 and 2021 with an annual percentage change of 16.50%, followed by a decline through 2024.

synapsesocial.com/papers/6a4b453d997070ff83b5b0aa https://doi.org/10.1016/j.jacadv.2026.102973

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Trends in Cardiac Arrest Mortality Among Young Adults in the United States, 1999 to 2024

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Trends in Cardiac Arrest Mortality Among Young Adults in the United States, 1999 to 2024

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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