Temporal Trends in Craniofacial Fractures-Related Mortality: A Retrospective Analysis of Older Adults Using CDC Wonder Database from 2001 to 2023

Introduction: Craniofacial Fractures (CFF) are a group of fractures that carry significant morbidity and mortality, especially in the elderly. Mortality trend analyses related to CFF among older adults in the United States are scarce. This mortality trend analysis examines national mortality trends in adults aged 65 years and older with CFF from 2001 to 2023. Methods: The CDC WONDER Multiple Cause-of-Death dataset (2001-2023) was used to evaluate mortality trends in adults 65 years and older using ICD-10 codes for CFF (S02). Results were stratified by place of death, year, and demographic and geographic distributions. Age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 persons with 95% confidence intervals (95% CI). Average annual percent change (AAPC) and annual percent change (APC) were calculated using Joinpoint regression software. Statistical significance was defined as p < 0.05. Results: A total of 17,493 CFF-related deaths occurred in older adults in the United States from 2001 to 2023. The majority of deaths occurred in medical facilities (59.89%), while hospices had the least number of deaths (6.60%). Overall AAMRs decreased from 19.35 in 2001 to 17.01 in 2023 (AAPC: -0.56; 95% CI: -1.14 to -0.15, p = 0.008). Men had approximately twice the average AAMR (24.98) compared to women (12.06). Racially, Non-Hispanic (NH) White individuals had the highest average AAMR (19.02), followed by Hispanic or Latino individuals (10.72), and NH other race individuals (10.42). Regionally, the Northeast had the highest average AAMR (22.62), followed by the Midwest (17.67), the West (16.61), and the South (14.93). Conclusion: CFF-related mortality rates have decreased from 2001 to 2023, with distinct disparities among demographic and geographical groups. Further research into evaluating the causative factors of such demographic and regional mortality disparities, as well as the implementation of public health strategies to rectify the mortality burden in at-risk communities, is crucial. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany