Temporal Trends in Electrolyte and Acid-Base Imbalance Mortality in the U.S. (1999- 2020): A Longitudinal Analysis

Background: Electrolyte and acid-base imbalance (EABI) has emerged as a critical contributor to rising mortality rates worldwide. This study aims to investigate the underexplored mortality trends associated with EABI in the United States from 1999 to 2020. Methods: Mortality data spanning 1999 to 2020 were retrieved from the CDC WONDER database, encompassing all age groups. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were analyzed. Joinpoint regression modeling was employed to calculate annual percentage changes (APCs). AAMRs were further stratified by race, sex, age, U.S. census region, and urbanization status. Results: Between 1999 and 2020, a total of 580,238 deaths were attributed to EABI. AAMRs declined from 1999 to 2008 (APC: -2.73), followed by a gradual increase from 2008 to 2018 (APC: 4.44), and a pronounced rise between 2018 and 2020 (APC: 12.08). Males exhibited consistently higher AAMRs (8.58) compared to females (7.29). Among racial groups, Non-Hispanic Blacks had the highest AAMR (12.70), while Asians had the lowest (5.45). Regionally, the South reported the highest AAMR (8.70), followed by the Midwest (7.78), Northeast (7.35), and West (7.06). Non-metropolitan areas had notably higher AAMRs (9.73) than metropolitan counterparts (7.49). Conclusion: The upward trend in EABI-related mortality over the study period is alarming and underscores the need for urgent public health interventions. Enhanced health education and preventive strategies are essential to mitigate EABI risk and reduce associated mortality in the future.