Trends and Disparities in Stroke and Sepsis-related Deaths Among Older Adults in the United States: A CDC WONDER Analysis, (1999-2023)
Sahil Jairamani1, FNU Sahil1, Muhammad Hanzalah Atif2, Fizzah Ikram Ul Haq3, Dhivya bharathi Govindaraj4, Raveen Mujeeb2, Muhammad Umar5, Dheeraj Kumar1
1MBBS, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan, 2MBBS, Dow University of Health Sciences, Karachi, Pakistan, 3MBBS, Allama Iqbal Medical College, Lahore, Pakistan, 4MBBS, Kazan State Medical University, Russia, 5MBBS, Khairpur medical college, Khairpur mir's, Pakistan
Background:
Stroke and sepsis have historically ranked among the leading causes of mortality in the US with approximately 795,000 Americans experiencing a stroke every year. Advances in healthcare procedures and public health policies over the past two decades have aimed to reduce the burden of these diseases. Analyzing the long-term mortality trends associated with both conditions is necessary to evaluate the effectiveness and the limitations of these health reforms.
Design/Methods:
Using the CDC WONDER multiple cause of death (MCD) database to extract death certificate data for adults aged ≥65 in the United States from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 were extracted for stroke (ICD-10 codes: I60-I64) and sepsis (A40-A41). Average Annual percent change (AAPC) with 95% confidence intervals (CIs) were calculated using JoinPoint regression analysis. Results were stratified by year, sex, race/ethnicity, age, urbanization, and Census regions.
Results:
A total of 166,876 stroke and sepsis-associated deaths were recorded over the study period. The AAMR per 100,000 decreased from 24.78 in 1999 to 14.17 in 2023 (AAPC: -2.14; 95% CI: -2.51 to -1.77). Men consistently had a higher AAMR (18.37) than women (14.03). Among all age groups, adults aged >85 recorded the highest mortality rate (38.68). The Non-Hispanic Black individuals had the highest mortality rate (37.37) among all the racial and ethnic populations. Mortality rates also varied by geographic regions, with the South reporting the highest rates (18.46).
Conclusions:
Mortality rates due to stroke and sepsis have decreased in the US over the last two decades. However, significant disparities still exist across different sexes, age, race/ethnicity, and geographic regions. These disparities highlight the need for targeted interventions and improvement of clinical care facilities in high-risk populations.
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