US Deaths From Head and Neck Injuries With Respiratory Failure Rose Steadily Over 27 Years

Deaths in the United States involving head or neck injuries combined with acute respiratory failure climbed steadily over more than a quarter century, according to a population-based analysis of national mortality data published in BMC Emergency Medicine. Between 1999 and 2025, a total of 29,574 deaths carried both an injury code for the head or neck and a code for acute respiratory failure somewhere on the death certificate, and the age-adjusted mortality rate rose from 0.2 to 0.5 per 100,000 population over the study period.

A death entered the analysis if the certificate mentioned an injury coded to ICD-10 categories S00–S09, covering head injuries, or S10–S19, covering neck injuries, together with J96.0, the code for acute respiratory failure. Because the codes could appear anywhere on the certificate, the study captures respiratory failure reported as a complication or contributing condition rather than only as the underlying cause of death.

They summarized the trajectory as an annual percent change of 4.2 percent, with a 95 percent confidence interval running from 3.6 to 5.2 percent, indicating a statistically significant upward trend across the full 27-year window. Rates were age-adjusted to account for shifts in the size and age structure of the US population, and the analysis was stratified by sex, age group, race and ethnicity, census region, individual state, metropolitan versus nonmetropolitan residence, and place of death.

The demographic pattern was consistent across the study period.

Geography also mattered.

The authors frame acute respiratory failure as an important terminal pathway after neurotrauma, encompassing traumatic brain injury and cervical spinal cord injury. The study does not establish which of these mechanisms drove individual deaths, but the co-reported codes indicate how often respiratory failure accompanies fatal head and neck injuries on death certificates.

Based on the observed disparities, the authors call for improved respiratory surveillance after neurotrauma, timely access to critical care, and targeted neurocritical care strategies for high-risk populations, particularly older adults and residents of nonmetropolitan areas. As a descriptive mortality analysis, the study identifies patterns and groups at elevated risk but cannot by itself establish causation or evaluate the effect of any specific intervention. The authors also note that national mortality patterns involving co-reported head or neck injury and acute respiratory failure had previously remained insufficiently described, which motivated the analysis.

Readers should note that the article is being shared early as a peer-reviewed, accepted version of record, citable under a permanent DOI, with a final version to follow.

Subject of Research: Temporal trends and disparities in US mortality involving head or neck injuries with acute respiratory failure, 1999–2025

Article Title: Deaths involving head and neck injuries and respiratory failure, 1999–2025: a population-based CDC WONDER mortality analysis

Article References: Omayer, A., Najib, M., Ahmed, R., Nawal, A., Anwar, M. F., Arif, Z., Khan, K., Shahid, T., Saouli, A., Nassar, M., Bala Musa, O. M., Babalola, A., Boudi, Z., & Hubloue, I. (2026). Deaths involving head and neck injuries and respiratory failure, 1999–2025: a population-based CDC WONDER mortality analysis. BMC Emergency Medicine. https://doi.org/10.1186/s12873-026-01828-w

Image Credits: AI Generated

DOI: 10.1186/s12873-026-01828-w

Keywords: CDC WONDER, mortality trends, head injury, neck injury, acute respiratory failure, neurotrauma, Joinpoint regression, age-adjusted mortality rate, health disparities, rural health, emergency medicine, death certificates