Background: Sepsis and acute renal failure (ARF) are major contributors to mortality in critically ill patients in the United States. Despite advancements in critical care, trends in mortality associated with these conditions among adults aged ≥55 years have not been well studied. Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was utilized to retrospectively analyze national mortality trends related to sepsis and ARF in the United States from 1999 to 2020, stratified by sex, race/ethnicity, age groups, U.S. Census region, and state. Results: The overall AAMR exponentially increased from 9.4 in 1999 to 18.5 in 2009 (APC: 7.73; 95% CI: 6.11 to 10.30) and it gradually increased to 22.6 in 2020 (APC: −0.14; 95% CI: −1.58 to 0.99, P -value = 0.819), with an average annual percentage (AAPC) of 3.53 (95% CI: 3.02 to 4.11, P -value = < 0.000001). Men had consistently higher AAMRs than women from 1999 (AAMR men: 12.4 vs. women: 7.5) to 2020 (AAMR men: 27.9 vs. women: 18.5), the AAPC for men is 3.22 (95% CI: 2.58 to 4.00) and for women is 3.96 (95% CI: 3.56 to 4.42). When stratified by race, the highest overall AAMR was observed in Black Americans (25.4%) and the lowest in Asians (13.4%). Overall, AAMR was highest for the South (19.5) and lowest for the Northeast (14). Conclusions: Following a period of dynamic fluctuations, sepsis and ARF-related mortality in U.S. adults have increased over the last 20 years. Focused interventions in prevention and treatment are crucial to mitigate the escalating impact of sepsis and ARF-related mortality.

Background: COPD and lung cancer are major global respiratory diseases, with COPD causing irreversible airflow limitation and lung cancer remaining a leading cause of cancer-related deaths.Analyzing mortality trends and health disparities is crucial for shaping effective public health policies and refining prevention strategies for diseases like COPD and lung cancer. Methods: Data was extracted from the CDC WONDER database, the ICD-10 codes used were C34.0-C34.3, C34.8, C34.9 and J41-J44. Age groups were categorized from 25 to 85 and above. We applied Joinpoint regression to calculate both annual and average annual percent change (AAPC) in mortality trends. Data were analyzed based on demographics, census regions, and levels of urbanization. Results: From 1999 to 2020 the total deaths recorded in U.S. were 484941. There was a significant decrease in the AAMR from 1999-2020 (AAPC: -1.40; 95% CI -1.79 to –1.00). COPD and lung cancer-related AAMRs were consistently higher in males than females, with NH White individuals having the highest rates and NH Asian or Pacific Islanders the lowest. Most racial groups saw declining mortality trends from 1999 to 2020, with notable reductions among Hispanics and NH Asian or Pacific Islanders, while NH White individuals initially experienced a slight increase before a steady decline. Nonmetropolitan areas consistently exhibited higher mortality rates than metropolitan areas, initially rising before trending downward, while metropolitan regions saw a continuous decline. Mortality patterns varied by location, with most deaths occurring at home or in medical facilities. Regionally, the Midwest reported the highest AAMR, while West Virginia had the highest state-level mortality rate and Utah the lowest. Conclusion Although COPD and lung cancer mortality have declined overall, persistent disparities across gender, race, and geographic regions underscore inequities in healthcare access. Targeted interventions are essential to bridge these gaps and improve COPD and lung cancer care nationwide.

BACKGROUND: Cardiac arrest(CA) and acute respiratory failure(ARF) are collectively at high risk of causing deaths among adults aged 25 and older in the United States. However, long-term trends to prevent these two coexisting conditions among adults are not well defined. OBJECTIVES: The objective of this study was to analyse mortality trends for CA with ARF among U.S. adults aged 25 years and older from 1999 to 2023. METHODS: Using the CDC WONDER Multiple Cause of Death database, we conducted a retrospective analysis of death certificates listing relevant ICD-10 codes for CA (I46) and ARF (J80, J96) among adults aged 25 years and older. Age-adjusted mortality rates (AAMRs) per 100,000 persons and the annual percentage change (APC) were calculated and stratified by demographics and geography. Trends were assessed using Joinpoint regression to estimate annual percentage change with 95% confidence intervals. RESULTS: From 1999 to 2023, 807,236 deaths were recorded. The overall AAMR showed a significant upward trend (AAPC: 4.06%), rising sharply to a peak in 2021 (28.56) before declining. Males consistently had higher AAMRs than females. Both of them increased till 2021 and later decreased. Racial differences were observed in that Non-Hispanic (NH) Black individuals had the highest average AAMR, while NH Whites had the lowest. Geographically, the Western census region had the highest AAMR, increasing to 37.5 in 2021 (APC: 23.92; 95% CI: 16.21 to 28.35; p=0.0004), and rural areas demonstrated higher mortality than urban areas(13.45 vs 10.53). Adults aged 65 and older showed the highest AAMR, with a sudden rise to 96.7 in 2021 (APC: 17.4; 95% CI: 11.7 to 20.7, p<0.000001), followed by a subsequent decline, compared with the other age groups. CONCLUSIONS: There was a marked AAMR due to CA and ARF over the past 24-year period, with a surge around the COVID-19 pandemic. Significant differences were observed by sex, race, and geography. These findings highlight that efforts are needed to prevent and manage mortalities by interventions among high-risk populations who have both HF and ARF.