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Updated: May 8, 2025
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Trends in sepsis-associated cardiovascular disease mortality in the United States, 1999 to 2022
Malik Salman1, Jack Cicin1, Ali Bin Abdul Jabbar1
1School of Medicine, Creighton University, Omaha, NE, United States.
Insights
Sepsis-associated cardiovascular disease (CVD) mortality initially declined but has risen in the US since 2013. This trend, along with demographic disparities, worsened after the COVID-19 pandemic.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Medicine
Background:
- Cardiovascular disease (CVD) is a leading cause of death in the US.
- Sepsis is a significant contributor to hospitalizations and mortality.
- Understanding sepsis-associated CVD mortality trends is crucial for public health interventions.
Purpose of the Study:
- To assess trends in sepsis-associated CVD mortality rates in the US from 1999 to 2022.
- To analyze variations in these mortality rates based on demographics (gender, race, age) and geographic regions.
- To identify changes in trends, particularly in relation to the COVID-19 pandemic.
Main Methods:
- Utilized the CDC WONDER database to identify deaths with both CVD and sepsis as causes.
- Analyzed data from 1999 to 2022, covering gender, race/ethnicity, age groups, and regions.
- Employed Joinpoint Regression to determine mortality trends and calculated age-adjusted mortality rates (AAMR).
Main Results:
- Total of 1,842,641 deaths with both CVD and sepsis listed.
- Sepsis-associated CVD mortality decreased from 1999-2013, then increased significantly by 2022 (AAMR 74.3).
- Highest mortality rates observed in men, non-Hispanic Black adults, and older adults; regional disparities showed increases in Northwest, Midwest, and Southern US.
Conclusions:
- Sepsis-associated CVD mortality has seen an overall increase in the US in the last decade.
- Demographic disparities in mortality rates have become more pronounced.
- The COVID-19 pandemic appears to have exacerbated both the general trend and existing disparities.
Purpose:
Cardiovascular disease (CVD) is the leading cause of death in the United States, and sepsis significantly contributes to hospitalization and mortality. This study aims to assess the trends of sepsis-associated CVD mortality rates and variations in mortality based on demographics and regions in the US.
Methods:
The Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to identify CVD and sepsis-related deaths from 1999 to 2022. Data on gender, race and ethnicity, age groups, region, and state classification were statistically analyzed to obtain crude and age-adjusted mortality rates (AAMR). The Joinpoint Regression Program was used to determine trends in mortality within the study period.
Results:
During the study period, there were a total of 1,842,641 deaths with both CVD and sepsis listed as a cause of death. Sepsis-associated CVD mortality decreased between 1999 and 2013, from AAMR of 65.7 in 1999 to 58.8 in 2013 (APC -1.06*%, 95% CI: -2.12% to -0.26%), then rose to 74.3 in 2022 (APC 3.23*%, 95% CI: 2.18%-5.40%). Throughout the study period, mortality rates were highest in men, NH Black adults, and elderly adults (65+ years old). The Northeast region, which had the highest mortality rate in the initial part of the study period, was the only region to see a decline in mortality, while the Northwest, Midwest, and Southern regions experienced significant increases in mortality rates.
Conclusion:
Sepsis-associated CVD mortality has increased in the US over the past decade, and both this general trend and the demographic disparities have worsened since the onset of the COVID-19 pandemic.
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