Introduction: Sepsis remains a leading cause of mortality among hospitalized patients, particularly in older adults with underlying infections such as Pneumonia. Despite advancements in critical care and antimicrobial therapies, population-level trends in sepsis-related mortality among pneumonia patients have not been thoroughly characterized over a long period. This study examines national mortality trends in adults aged 55 years and older with pneumonia and sepsis concurrently from 1999 to 2020. Methods: A retrospective analysis of CDC-WONDER mortality data (1999-2020) in the USA identified patients aged 55 and older with Pneumonia who had Sepsis, using ICD-10 codes A02-42, B37.7, and J12-18, respectively. Results were stratified demographically and geographically. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated with 95% CI. Annual percent change (APC) and average annual percent change (AAPC) were determined using Joint-point regression. Grammar checking tools were utilized to correct written materials in the project. Results: Seven hundred thirty thousand five hundred seventy-nine deaths were reported in total in the United States between 1999 and 2020 for sepsis with pneumonia among patients aged ≥55 years. The AAMR grew from 45.42 in 1999 to 65.71 in 2020, with an AAPC of 1.91 (95% CI: 0.66–3.18). Higher AAMRs were observed in men (57.35%) than in women (37.12%). Non-Hispanic Black or African Americans had the highest AAMR (69.94), followed by Hispanics, NH American Indian or Alaska Native, Pacific Islander, and NH White, with the sharpest AAPC among Hispanics. The South had the highest AAMR (49.82) state-wise, with the Midwest showing the most evident increase (AAPC: 2.31). Rural areas had higher AAMRs (45.39) than metropolitan areas (45.29). Conclusions: Despite overall improvements in healthcare, sepsis-related mortality among older pneumonia patients has increased over the past two decades, with notable disparities across sex, race, region, and urbanicity. The disproportionately higher mortality rates observed in men, non-Hispanic black populations, and residents of rural and southern areas underscore an urgent need for targeted public health interventions, equitable resource allocation, and early detection strategies to mitigate preventable deaths in high-risk groups.
Memon et al. (Sun,) studied this question.