TRENDS AND DISPARITIES IN MORTALITY DUE TO ACUTE RENAL FAILURE AND SEPSIS IN THE UNITED STATES-A 21-YEAR MORTALITY ANALYSIS FROM THE CDC WONDER DATABASE

 

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TRENDS AND DISPARITIES IN MORTALITY DUE TO ACUTE RENAL FAILURE AND SEPSIS IN THE UNITED STATES-A 21-YEAR MORTALITY ANALYSIS FROM THE CDC WONDER DATABASE

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Abdulqadir
Nashwan
Iqra Shahid Iqrashahid1412@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Minhal Chaudhry minhalchaudhry42@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Ayeza Nawaz ayezanawaz68@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Abdulqadir Nashwan anashwan@hamad.qa Hamad Medical Corporation Nursing & Midwifery Research Department Doha Qatar *
Muneeb Ahsan muneebahsan1029@gmail.com Allama Iqbal Medical College College of Medicine Lahore Pakistan -
Muhammad Wali Hassan walihassanmwh@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Zaryab Bacha zaryab03443578390@gmail.com Khyber Medical College College of Medicine Peshawar Pakistan -
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Acute renal failure occurs when the kidneys stop working suddenly and can't filter waste products from the blood. Sepsis is a serious, life-threatening reaction to an infection that causes organ failure. Sepsis is a major cause of acute renal failure. About two-thirds of patients with septic shock develop acute renal failure. This study examined the trends in acute renal failure and sepsis-related mortality in the U.S. from 1999 to 2020.

We used the death certificates from the CDC Wonder database to calculate age-adjusted mortality rates (AAMR) and crude mortality rates (CMR) per 100,000 persons from 1999 to 2020. AAMRs were stratified by year, gender, race, and geographical distribution. Annual percentage changes (APC) in AAMR with 95% CI were obtained using Joinpoint regression analysis.

A total of 302,526 deaths related to acute renal failure and sepsis were recorded between 1999 and 2020. The AAMR increased significantly from 2.28 in 1999 to 4.47 in 2009 (APC= 7.32, 95% CI= 5.34 to 9.34, p<0.01) and then finally increased to 5.74 in 2020 (APC= 0.74, 95% CI= -0.40 to 1.89, p=0.19). Men had consistently higher overall AAMR as compared to women (men= 4.95 vs women=3.50). NH Black had the highest overall AAMR (6.25), followed by NH American Indian (4.77), NH White (3.91) and NH Asian (3.10). CMRs also increased with the advancing age and were greatest in individuals over the age of 85 years. The South exhibited the highest overall AAMR (4.78) followed by the West (4.11), the Midwest (3.72) and the Northeast (3.28). Upon stratification by urbanization, non-metropolitan areas had the higher overall AAMR (non-core areas: 4.25; micropolitan areas: 4.32) than the metropolitan areas (large central metropolitan areas:4.22 ;large fringe areas: 3.79).The highest AAMR was observed in Texas (6.79) and South Carolina (6.19), whereas the lowest was observed in Vermont (2.19) and Montana (2.41).

An overall increase in mortality related to acute renal failure and sepsis has been observed in the United States from 1999-2020.The highest mortality rates were found in men belonging to NH Black ethnicity in the non-metropolitan areas of the Southern region. Because of persistent disparities, further research with targeted interventions is needed to address underlying inequities in healthcare access and outcomes.

Kewords