Work

Geographic and demographic disparities in sepsis and renal failure mortality: a CDC WONDER-based narrative review of 1999–2020 trends

Year: 2025

Type: review

Abstract: Background: Sepsis and acute renal failure (ARF) are major contributors to mortality in critically ill patients in the United States. Despite advancements in critical care, trends in mortality associated with these conditions among adults aged ≥55 years have not been well studied. Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was utilized to retrospectively analyze national mortality trends related to sepsis and ARF in the United States from 1999 to 2020, stratified by sex, race/ethnicity, age groups, U.S. Census region, and state. Results: The overall AAMR exponentially increased from 9.4 in 1999 to 18.5 in 2009 (APC: 7.73; 95% CI: 6.11 to 10.30) and it gradually increased to 22.6 in 2020 (APC: −0.14; 95% CI: −1.58 to 0.99, P -value = 0.819), with an average annual percentage (AAPC) of 3.53 (95% CI: 3.02 to 4.11, P -value = < 0.000001). Men had consistently higher AAMRs than women from 1999 (AAMR men: 12.4 vs. women: 7.5) to 2020 (AAMR men: 27.9 vs. women: 18.5), the AAPC for men is 3.22 (95% CI: 2.58 to 4.00) and for women is 3.96 (95% CI: 3.56 to 4.42). When stratified by race, the highest overall AAMR was observed in Black Americans (25.4%) and the lowest in Asians (13.4%). Overall, AAMR was highest for the South (19.5) and lowest for the Northeast (14). Conclusions: Following a period of dynamic fluctuations, sepsis and ARF-related mortality in U.S. adults have increased over the last 20 years. Focused interventions in prevention and treatment are crucial to mitigate the escalating impact of sepsis and ARF-related mortality.

Source: Annals of Medicine and Surgery

DOI: 10.1097/ms9.0000000000004483