• Peter Rhee, John B Holcomb, and Bardiya Zangbar.
• Department of Surgery, Saint Barnabas Hospital, Bronx, New York.
• Ann. Surg. 2025 Feb 11.

BackgroundOver the past two decades, the epidemiology of trauma has shifted significantly, driven primarily by demographic changes. Aim of our study was to illustrate the changing landscape of trauma mortality rates and compare them with other leading causes of death.MethodsWe performed a cross-sectional study from 2000-2020, using data from the CDC and WISQARS™. Trauma deaths were defined according to the WHO classification, encompassing unintentional injuries, homicides, and suicides. Mortality rates were calculated per 100,000 using US census data.ResultsThe analysis revealed a 91% increase in trauma mortality from 2000-2020, rising to 268,926 deaths-far surpassing the 17.8%population growth. A trimodal distribution of trauma deaths persisted, with age peaks shifting to 30-35,55-59, and above 70 years by 2020. Causes of death shifted with increases in firearm, poisoning, and fall, while motor vehicle mortality rates declined. By 2020, trauma was the leading cause of death up to age 50. Trauma remained the leading cause of cumulative deaths up to age 67 and the primary contributor to years of life lost. Death rates from cancer and heart disease showed a declining trend.ConclusionsTrauma has become the leading cause of death up to age 50 and remains a primary contributor to years of life lost. The largest increase in trauma deaths was noted among baby boomers and millennials. As death rates from cancer and heart disease decline, it is essential to reprioritize and reallocate resources to address the evolving trauma epidemiology in an aging and expanding U.S. population.Level Of EvidenceLevel III retrospective study.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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