Temporal trends in U.S. mortality from liver cirrhosis and sepsis: A 25-year retrospective analysis (1999-2023)

Sepsis and liver cirrhosis frequently co-occur, compounding mortality risk. However, national mortality trends involving both remain insufficiently explored. Therefore, this study aims to evaluate national trends in mortality involving coexisting liver cirrhosis and sepsis among United States adults from 1999 to 2023. We analyzed Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research data from 1999 to 2023 for adults aged ≥ 25 years with sepsis and cirrhosis listed as causes of death. Age-adjusted mortality rates per 100,000 were calculated using the 2000 United States standard population. Joinpoint regression estimated annual percent change and average annual percent change; P < .05 was considered significant. Overall, 112,937 deaths involved both liver cirrhosis and sepsis, with Age-adjusted mortality rates increased significantly during 2009 to 2015 and 2018 to 2021. Males (2.35), non-Hispanic American Indians (3.82), and elderly individuals (3.99) had the highest rates. Further south region (2.24) and rural geographics (average annual percent change: 4.45) showed peak mortality rates. Mortality from coexisting sepsis and cirrhosis is rising, especially among American Indian individuals, minorities, males, older adults, and rural populations, underscoring disparities in care and the need for targeted interventions.