Trends in sepsis-related mortality among adults with cancer aged ≥ 25 years in United States, 1999-2020: A CDC WONDER study.

Abstract

e22600 Background: Sepsis is one of the leading causes of death worldwide, while mortality in patients with cancer and sepsis is significantly higher than mortality in patients without cancer. Our study seeks to analyze trends in the age-adjusted mortality rate (AAMR) for sepsis-related deaths in adult patients (≥ 25 years old) with cancer in the United States from 1999 to 2020 using data from the recent CDC WONDER database. This analysis revealed significant temporal patterns, providing a framework for future studies and public health initiatives. Methods: The CDC WONDER database was used to track sepsis-related deaths in adult cancer patients in the United States from 1999 to 2020. This study analyzed the temporal mortality patterns in adults, categorized by age group, gender, race, census region, and urban/rural residency, using the joint point regression tool. We calculated the annual percent change (APC) and the average annual percent change (AAPC), and we applied 95% confidence intervals. Results: During 1999-2020, 599,604 deaths occurred in the United States involving cancer and sepsis. AAMR initially showed a decline in mortality; however, a significant surge in mortality was observed in 2013 [APC = 3.57 (95% CI 2.55 to 4.10)], with an overall AAPC of 0.28. Male patients consistently maintained a higher mortality rate; there was a notable increase in the trend in female patients, which was recorded [AAPC = 0.35 (95% CI 0.21-0.54)]. Analysis by race showed American Indian or Alaska Native patients had the greatest surge in AAMR, which significantly went high [AAPC = 2.38 (95% CI 1.65-3.43)], while Black or African American patients showed the highest mortality rate. The mortality burden increased with age, being highest at the 45-85+ age range. Regional analysis revealed that the West experienced the most significant rise in AAMR [AAPC = 0.77 (95% CI 0.54-1.16)]. A persistent disparity was observed between rural and urban populations, with rural individuals consistently demonstrating a higher AAMR compared to urban individuals [AAPC = 1.00 (95% CI, 0.82 to 1.24)]. Conclusions: Our analysis reveals substantial inequalities by gender, ethnicity, age, and region. These findings reveal important insights for future studies and policy efforts to lower mortality, especially for individuals at high risk.