Mortality trends from sepsis and gastrointestinal cancer among United States adults: A CDC WONDER–based analysis.

Abstract

e15673 Background: Sepsis is a major contributor to mortality among patients with gastrointestinal (GI) cancers. Population-level related mortality trends and disparities among the United States population remain underexplored. This study evaluates national trends and demographic differences in GI cancer-related sepsis mortality in the United States. Methods: We analyzed mortality data from the CDC WONDER Multiple Cause-of-Death dataset from 1999 to 2023. We calculated age-adjusted mortality rates (AAMRs) per 100,000, stratified by age, sex, race/ethnicity, states, and urban-rural classification. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p<0.05. Results: Between 1999 and 2023, 171,744 deaths occurred from GI cancer-related sepsis. The AAMR per 100,000 raised from 2.98 in 1999 to 3.81 in 2023 (AAPC: 1.26%; 95% CI: 0.97-1.55; p<0.001). Males showed a higher mean AAMR of 3.91 versus 2.28 in females. Age analysis showed the highest mortality rate in the age group of more than 65 years (10.55). By race, non-Hispanic (NH) Black or African American individuals had the highest AAMR (4.90), followed by NH Asian or Pacific Islander (3.48), Hispanic or Latino (3.46), NH American Indian or Alaska Native (3.04), and NH White (2.75). Urbanization disparities revealed higher AAMRs in Metropolitan (2.95) than Non-Metropolitan areas (2.70). The Northeast region had the highest AAMR (3.18), followed by the West (3.17), the South (3.01), and the Midwest (2.62). In state-wise analysis, the District of Columbia had the highest AAMR (6.12), while the state of Maine had the lowest (0.94). Conclusions: GI cancer-related sepsis mortality in the United States has increased significantly over the past two decades, with significant disparities by sex, race/ethnicity, geography, and urbanization. These findings underscore the need for equity-focused interventions and enhanced clinical recognition of demographic-based risk factors, which could lead to a quicker estimation of the prognosis and improved sepsis management in cancer care. Deaths and age-adjusted mortality rates (AAMRs) per 100,000 for trends related to sepsis and gastrointestinal cancer mortality among United States adults between 1999 and 2023. Variable Deaths (n) AAMR (95% CI) Overall 171,744 3.00(2.93-3.07) SEX Male 99,411 3.91(3.78-4.03) Female 72,333 2.28(2.19-2.36) RACE/ETHNICITY NH American Indians 1313 3.04(2.20-4.10) NH Asians 8200 3.48(3.07-3.89) NH Blacks 27747 4.90(4.60-5.20) NH White 130374 2.75(2.67-2.82) Hispanics 17114 3.46(3.17-3.74)