Sepsis patients are highly susceptible to atrial fibrillation (AF) and atrial flutter due to the proinflammatory and adrenergic milieu, which precipitates arrhythmogenesis, especially in vulnerable individuals. Understanding mortality trends and disparities in this population is essential for targeted interventions. We analyzed US death certificates from the Center of Disease Control Wide-Ranging Online Data for Epidemiologic Research database for individuals aged ≥25 years who died between 1999 and 2023 with both sepsis and AF listed as causes. We calculated age-adjusted mortality rates (AAMRs), which measure changes in death rates over time while accounting for differences in age distribution, and annual percent change to evaluate yearly trends in these rates across demographic groups stratified by year, sex, age group, race/ethnicity, geographic region, and urbanization status. A total of 2,40,222 deaths involved both AF/atrial flutter and sepsis. The overall AAMR increased from 2.0 per 1,00,000 in 1999 to a peak of 7.9 in 2021 (annual percent change +5.6% through 2018, accelerating to +12.6% through 2021), with a slight decline to 7.1 by 2023. Mortality was consistently higher in men than women, older adults, residents of nonmetropolitan areas, and the US South. By race/ethnicity, non-Hispanic White and Black individuals had the highest AAMRs, followed by American Indian/Alaska Native, Hispanic, and Asian/Pacific Islander populations. Deaths involving AF and sepsis have risen substantially over the past 4 decades, with sharp increases in recent years and persistent disparities by age, sex, race/ethnicity, and geography. These findings underscore the need for integrated arrhythmia–sepsis management strategies, enhanced access to critical care in underserved regions, and equity-focused public health interventions to mitigate mortality.

Background/Objectives: Cardiac arrest and fluid, electrolyte, and acid–base disorders frequently coexist in critically ill patients and are associated with poor clinical outcomes. However, long-term population-level trends in mortality involving both conditions remain poorly characterized. This study evaluated temporal trends and demographic disparities in mortality involving cardiac arrest and fluid, electrolyte, and acid–base disorders among U.S. adults from 2004 to 2024. Methods: We conducted a retrospective population-based study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database. Adults aged ≥25 years with cardiac arrest (ICD-10: I46) and fluid, electrolyte, and acid–base disorders (ICD-10: E87) listed anywhere on the same death certificate between 2004 and 2024 were included. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC), with analyses stratified by demographic and geographic characteristics. Results: A total of 152,937 deaths involved both cardiac arrest and fluid, electrolyte, and acid–base disorders during the study period. The AAMR nearly doubled, increasing from 2.06 (95% CI, 2.00–2.13) in 2004 to 4.08 (95% CI, 4.00–4.16) in 2024, corresponding to an overall AAPC of 3.42% (95% CI, 2.58–4.26; p < 0.001). Mortality remained consistently higher among males, adults aged ≥65 years, and non-Hispanic Black individuals, with significant increases observed across all demographic groups. The West demonstrated the highest regional mortality burden (AAPC, 3.75%; p < 0.001). Urbanization analyses (2004–2020) showed higher mortality in non-metropolitan than metropolitan areas (AAPCs, 5.36% vs. 4.13%; both p < 0.001). Mortality increased through 2021 before declining modestly during 2021–2024. Conclusions: Mortality involving both cardiac arrest and fluid, electrolyte, and acid–base disorders increased substantially in the United States over the past two decades, with persistent disparities in age, sex, race/ethnicity, and geography. These findings identify populations at increased risk and support targeted public health strategies, equitable healthcare access, and improved recognition and management of metabolic disturbances in patients at risk for cardiac arrest.

Type 2 diabetes mellitus (T2DM) and malignant neoplasms are among the most prevalent chronic diseases worldwide. When coexisting, they substantially increase morbidity and mortality. However, national trends in mortality among patients with coexisting T2DM and malignant neoplasms in the United States remain underexplored. We analyzed U.S. death certificates from the CDC WONDER database for individuals aged ≥ 25 years who died between 1999 and 2024 with both T2DM and malignant neoplasms listed anywhere on the death certificate (underlying or contributing causes). Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age group, race/ethnicity, geographic region, and urbanization status. From 1999 to 2024, 357,910 U.S. deaths occurred among individuals in whom both Type 2 Diabetes Mellitus and Malignant Neoplasms were listed on the death certificate. The AAMR rose from 6.37 to 17.2 per 100,000, with an overall APC of + 3.84%. Men exhibited higher mortality than women. Older adults bore the greatest burden, though middle-aged adults also showed a sharp proportional rise. Hispanic and Asian populations experienced the steepest increases. The West region showed the most pronounced growth. State-level variation exceeded fivefold, with Nebraska reporting the highest AAMR and Nevada the lowest. nonmetropolitan areas maintained higher mortality throughout, but metropolitan areas demonstrated a steeper rise, narrowing the rural–urban gap. Mortality among individuals with coexisting T2DM and malignant neoplasms has risen substantially in the U.S., with disproportionate increases among men, minority populations, and urban residents. These findings highlight the urgent need for integrated strategies addressing diabetes control, cancer prevention, and health equity across demographic and geographic subgroups.