A new study reveals that sepsis-related deaths in the United States have significantly increased from 1999 to 2022, highlighting alarming trends in mortality rate variations based on demographic factors such as gender, race, age, and geography.
An analysis of data sourced from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) indicated that between 1999 and 2022, a staggering 4,177,071 deaths occurred due to complications arising from sepsis.
The research utilized the Multiple Cause-of-Death Public Use Record and death certificate records to extract sepsis-related death data, focusing on individuals aged 25 years and older, as those under this age group are generally less affected by sepsis-related fatalities.
The study employed the International Classification of Diseases, 10th Revision (ICD-10) codes A40-A41 to identify sepsis-related mortality and its associated causes, revealing significant demographic and geographic disparities in outcomes.
Men experienced notably higher age-adjusted mortality rates compared to women, prompting researchers to explore the potential behavioral and health care access factors that may contribute to these gender-based differences.
For males, the average annual percentage change (AAPC) from 1999 to 2019 was minimally impactful at -0.0013, with a percentage change in age-adjusted mortality rate (AAMR) of -2.23%.
In contrast, women showed a more significant decline, with an AAPC of -0.15 and a -2.75% PC in AAMR over the same period.
However, the COVID-19 pandemic seemed to radically alter these trends, as the percentage change in AAMR from 2019 to 2021 for women jumped to 27.29% and for men to 31.96%.
The racial stratification of data unveiled disturbing patterns, with the Black or African American group recording the highest AAMR among all racial demographics studied.
From 1999 to 2019, this group reported an AAPC of -1.6, accompanied by a percentage change in AAMR of -30.23%.
In comparing the years 2019 to 2021 to this earlier period, the PC in AAMR escalated to 34.09%, indicating a severe rise in mortality disparities exacerbated during the pandemic.
The American Indian or Alaska Native population accounted for the second highest AAMR during the first analysis period, with a staggering percentage increase of 47.12% in AAMR over the subsequent two years.
Notably, the Hispanic group also exhibited a significant increase in AAMR, with a PC of 49.48% from 2019 to 2021 despite reporting a lower overall AAMR compared to other minority groups.
Meanwhile, the non-Hispanic White population demonstrated a different trajectory, with the second-lowest AAMR and a notable trend toward an increased percentage change during the latter portion of the study due to the opioid crisis.
The elderly population, particularly those aged 75 and older, registered the highest rate of mortality related to sepsis, with the middle-aged group showing alarming increases in deaths as well.
Young adults aged 25 to 44 years who typically might see lower AAMR also experienced concerning increases, potentially linked to rising rates of intravenous drug use and its complications.
Geographically, all regions of the United States fell under the influence of rising AAMR post-2019.
Southern states showed the highest mortality rates, reinforcing prior studies that identified rural healthcare access as a significant determinant of sepsis outcomes.
A comprehensive review of common associated causes of sepsis-related deaths revealed that pneumonia remained the leading cause of such fatalities.
The share of pneumonia-related deaths increased sharply from 20.77% from 1999-2001 to 27.63% over the period from 2020-2022, reflecting the burden placed on healthcare systems during the COVID-19 pandemic.
In contrast, the percentage of sepsis deaths associated with chronic lower respiratory diseases saw a marked decline amidst the rising COVID-19 mortality rates, dropping to 1.50% from 2020-2022.
The study’s findings emphasize that COVID-19 acted as a unique catalyst in transforming sepsis-associated mortality rates, dramatically impacting all demographics.
Sensitivity analysis confirmed that nearly all excess AAMR noted during the pandemic years was driven by COVID-19-associated sepsis mortality, illustrating profound impacts of the pandemic on public health outcomes.
Researchers noted that understanding these trends and variations is crucial to addressing health disparities in sepsis and informing healthcare policy aimed at better management and prevention strategies for such a life-threatening complication.
While researchers emphasized the impressive strengths of the study, especially its reliance on the robust CDC WONDER database, they cautioned against potential biases and limitations, including misclassification and the lack of data on confounding variables.
These demographics-driven insights will be instrumental in forming future public health initiatives aimed at reducing sepsis-associated mortality rates and improving healthcare access and equity across the United States.
image source from：https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10921-7
