Trends in Pneumonia and Sepsis-Related Mortality Across the United States, 1999– 2024: A CDC WONDER-Based Population Study

Purpose This research investigated the national patterns and inequalities in mortality associated with pneumonia-related sepsis in the United States from 1999 to 2024. The study explored the variations in mortality rates over time as well as among different demographic and geographic groups, with the objective of pinpointing high-risk populations to inform prevention and early intervention approaches. Methods Retrospective population evaluation was performed utilizing the CDC WONDER Multiple Cause-of-Death database from 2000–2023. Adults aged ≥ 25 years with sepsis (ICD-10 A40–A41) and pneumonia (ICD-10 J12–J18) on death certificates were analyzed. Age-adjusted mortality rates (AAMRs) were estimated per 100,000 population based on the 2000 U.S. standard population. Temporal patterns were examined through Joinpoint regression to determine the annual percent change (APC) and mean annual percent change (AAPC), stratified for sex, race, region, urbanization, and age. Results 1,039,577 pneumonia-sepsis fatalities were recorded from 1999 to 2024. AAMR increased from 16.6 in 1999 to 18.2 in 2024, peaking acutely in 2018–2021 and then decreasing. Mortality was higher in men (21.9) compared to women (14.4), and highest in non-Hispanic Blacks (27.5). The South had the highest burden (19.7), with significant differences throughout the different states. Adults 65 and above had the highest mortality (69.3), and rural and urban areas had parallel curves. Conclusion Sepsis related to pneumonia continues to have a significant U.S. mortality burden, with striking variation by sex, race, geography and age. The 2018–2021 surge highlights the burden of public health emergencies and the need for concentrated, equitable prevention and care interventions.