an increasing trendP = 0.01
The overall mortality trend remained stable from 1999 to 2019 (AAPC: −0.09, 95% CI: −0.89 to 0.98), with an increasing trend in AAMRs from 1999 to 2006 (APC: 3.87, 95% CI: 1.15–9.68) ( P = 0.01), followed by a substantial decrease from 2006 to 2009 (APC: −18.95, 95% CI: −23.57 to −8.84) ( P = 0.0004), and a noticeable increase from 2009 to 2019 (APC: 3.52, 95% CI: 1.60–6.99) ( P = 0.001) (Graphical Abstract, Supplemental Digital Content 1, https://links.lww.com/CAEN/A70 ).