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Mortality trends in elderly patients with disseminated intravascular coagulation: a retrospective CDC WONDER Analysis
Piyush Ratan1, Kritika2, Umair Iqbal3
1Patna Medical College, Patna, India.
Insights
Mortality from disseminated intravascular coagulation (DIC) in older adults initially decreased but has recently risen. Significant racial and regional disparities persist, highlighting the need for targeted interventions to address these inequalities.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- Disseminated intravascular coagulation (DIC) is a serious condition with rising mortality trends in the general US population.
- Mortality trends specifically in older adults (over 65) with DIC have not been previously analyzed.
Purpose of the Study:
- To analyze mortality trends in elderly patients diagnosed with disseminated intravascular coagulation (DIC) in the United States.
- To identify demographic and geographic disparities in DIC-related mortality among older adults.
Main Methods:
- Analysis of death certificate data from the CDC WONDER database (1999-2020).
- Calculation of age-adjusted mortality rates (AAMR) and annual percentage change (APC).
- Stratification of mortality data by age, sex, race/ethnicity, and geographic region.
Main Results:
- Overall age-adjusted mortality for DIC in adults >65 decreased from 6.4 to 4.0 per 100,000 until 2015, then slightly increased.
- Mortality trends varied significantly by sex, race, and region, with African Americans and the Southern US experiencing the highest burden.
- A majority of DIC-related deaths (93.1%) occurred within medical facilities.
Conclusions:
- Despite an overall decrease, DIC-related mortality in older adults shows a recent upward trend.
- Persistent disparities in mortality burden exist among racial groups (highest in African Americans) and geographic regions (highest in the Southern US).
- Targeted interventions and enhanced surveillance are crucial to address these disparities and mitigate rising mortality.
Introduction:
A rising trend in mortality due to disseminated intravascular coagulation (DIC) was observed in the US population. However, DIC-related mortality trends among older adults > 65 years have not been investigated before. The objective of the study was to analyze the mortality trends in elderly patients with DIC.
Material And Methods:
Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) database were analyzed from 1999 to 2020 for DIC-related mortality in elderly patients > 65 years of age. Age-adjusted mortality rates (AAMR) per 100,000 people and annual percentage change (APC) were calculated and stratified by age, sex, race/ethnicity, and geographic region.
Results:
This study examines the mortality trend in older patients (> 65 years) with disseminated intravascular coagulation between 1999 and 2020. Out of the total 39,853 deaths, 93.1% occurred in medical facilities. From 6.4 to 4.0 per 100,000, the overall age-adjusted mortality (AAMR) decreased steadily until 2015, followed by a slight increase. Mortality trends varied by sex, race, and geographic region, with African Americans showing the highest AAMR and the Southern U.S. reporting the highest regional burden. The necessity for focused treatments to address racial and regional disparities in DIC-related mortality is underscored by persistent differences, even when overall trends indicate improvement.
Conclusions:
Although DIC-related mortality decreased between 1999 and 2020, a recent upward trend has been observed. Notable disparities persist, with the Southern region and non-Hispanic African Americans experiencing the highest burden. Targeted interventions and enhanced surveillance are essential to address these inequalities and prevent further increases.
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