Trends and Disparities in Sepsis and Acute Stroke-Related Mortality Rates among Adults in the United States (1999-2023): A CDC Wonder Analysis

Background Sepsis and stroke are the leading causes of death in the United States with stroke accounting for 1 out of every 20 deaths each year. Sepsis increases the risk of stroke by causing hypercoagulable state, triggering inflammation, endothelial dysfunction and disseminated intravascular coagulation (DIC) resulting in microthrombi formation, hypoperfusion of the brain leading to stroke. This study aims at analyzing the trends and disparity in sepsis and stroke related mortality rates in the United States from 1999–2023. Methods This retrospective study uses CDC WONDER database from 1999–2023 for Sepsis and Stroke to analyze mortality trends using CDC-10 code (A40-41) for sepsis and (160–164) for stroke. Age adjusted mortality rates (AAMR) per 100,000 were obtained and analyzed for overall mortality, gender, age, race and ethnicity, states, urbanization and census region. Join point analysis regression analyzed AAMR and annual percent change (APC). Results From 1999–2023 sepsis and stroke accounted for 209,719 deaths in the United States. Majority of deaths occurred in medical facilities (77.8%) with AAMR of 4.59 in 1999 followed by decrease to 3.04 in 2023. Higher AAMR's are observed in Males, Older age groups, Blacks, Hispanics and Non-metropolitan areas. States in the top 95th percentile included District of Columbia, Mississippi and Oklahoma which had five to six times higher AAMR's than states in 5th percentile. Peaks in mortality trends of demographic factors were observed, coinciding with Covid-19 pandemic. Conclusions: Disparity among Males, Old age, Black, Non-metropolitan, South and several states in mortality highlights the need for future studies to identify risk factors. Timely diagnosis, prompt treatment, effective use of technology and telemedicine can reduce morbidity and mortality.