Mortality Patterns and Trends in Fars Province, Iran (2015-2024): A Retrospective Analysis of Death Records.

BACKGROUND: Provincial mortality profiles are essential for local prevention and health-service planning. However, they are reported less frequently than national summaries in Iran. We described cause-of-death patterns and temporal changes in Fars Province from 2015 to 2024, including the disruption during the coronavirus disease 2019 pandemic. METHODS: We analyzed death registration records from the Fars provincial civil registration system, including age, sex, residence status, place of death, and an underlying cause coded using the International Classification of Diseases (ICD), 10th revision, and mapped to major cause groups. We summarized distributions by key strata and assessed temporal patterns using annual counts and within-registry proportions. Trend tests and multivariable logistic regression evaluated associations of calendar year and pandemic period with major cause groups, while unsupervised clustering summarized mortality profiles among non-neonatal records. RESULTS: After cleaning, 199,107 records were included. Diseases of the circulatory system accounted for 45.4% of deaths, followed by respiratory diseases, neoplasms, and external causes. All-cause deaths rose sharply in 2020-2021, with concurrent increases in respiratory and infectious causes. Cause composition varied by residence status and place of death, and clustering distinguished younger external-cause deaths from older disease-dominant profiles. CONCLUSION: Mortality in Fars Province during 2015-2024 was dominated by circulatory diseases, with heterogeneity by demographic and contextual factors and a major pandemic-era increase in deaths. The findings supported prioritizing cardiovascular risk reduction and timely acute care, targeted injury prevention for younger groups, strengthened rural access to prevention and emergency services, and preparedness for future infectious surges.