Trends in non-Hodgkin lymphoma and sepsis-related mortality among older adults, 1999–2020: A CDC WONDER database analysis.

Abstract

e19067 Background: Non-Hodgkin lymphoma (NHL) is the sixth most common malignancy and the most prevalent type of lymphoma. Patients with NHL are at an elevated risk of sepsis, primarily due to immune system suppression associated with the disease. Sepsis affects almost 1 in 20 cancer patients during hospitalization. This study aims to analyze mortality trends in NHL patients associated with sepsis among older adults (aged 65+) in the United States (US), and to assess demographics and geographic variations in these trends over time. Methods: The CDC WONDER public database was utilized to retrieve death certificates for patients aged 65 and older in the United States from 1999 to 2020, using ICD-10 codes C85.9 (non-Hodgkin lymphoma, unspecified) and A41.9 (Septicemia, unspecified). Demographic variables, including gender, race, urbanization, census region, and state of residence, were incorporated to calculate age-adjusted mortality rates (AAMR) per 100,000 population. Statistical significance was determined at a p-value of <0.05. Results: From 1999 to 2020, a total of 20,817 deaths related to NHL and sepsis occurred among older adults, representing approximately 7% of all NHL-related deaths. The overall age-adjusted mortality rate (AAMR) decreased from 3 per 100,000 in 1999 to 1.4 per 100,000 in 2020. Males consistently exhibited higher AAMR compared to females with overall rates of 3 and 1.8, respectively. Among racial groups, Hispanics had the highest overall AAMR (2.4), followed closely by Non-Hispanic Whites (2.3). Geographically, metropolitan areas showed a higher overall AAMR (2.4) compared to non-metropolitan areas (2.0). Regionally, the Northeast exhibited the highest AAMR, while the Midwest and South shared an AAMR of 2.2, followed by the West at 2.1. States in the 90th percentile (New Jersey, Rhode Island, Connecticut, Ohio, West Virginia) have an average AAMR approximately 3 times higher than those in the 10th percentile. Conclusions: Although the overall age-adjusted mortality rates for NHL and sepsis have declined, significant disparities persist across different demographics and geographic groups. Males, Hispanics and individuals residing in metropolitan areas remain at higher risk. Targeted interventions and strategic resource allocation are essential to address these disparities and enhance patient outcomes.