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Abstract: FR-PO0080

Trends and Disparities in Sepsis-Related Mortality in Patients with AKI in the United States, 1999-2020

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Gandhi, Dhruv, St Francis Medical Center, Monroe, Louisiana, United States
  • Ahmad, Wajdan, Al Tibri Medical College, Karachi, Sindh, Pakistan
  • Maniar, Romil Hemal, St agnes ascension, Baltimore, Maryland, United States
  • Sawale, Mihika, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
  • Bendre, Adwait Suhas, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
  • Deshmukh, Indraneel Abhijit, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
Background

Aim is to determine trends and disparities in sepsis-related mortality of American acute kidney injury(AKI) patients older than 45 years of age from 1999-2020.

Methods

Retrospective analysis of Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was performed. Age-adjusted mortality rates(AAMR) and crude death rates per 100,000 persons were determined. Average annual percentage change(AAPC) was determined using Joinpoint regression. Temporal trends were analyzed in sex, race, geographical distribution and patient age-related mortality.

Results

50,481 deaths in AKI patients from sepsis were reported. Overall AAMR was 1.95(AAPC:1.40;p<0.001). AAMRs from 1999-2020 showed a bidirectional trend, with initial rapid increase from 1.35 to 2.27 between 1999-2008(AAPC:6.08;p<0.0001), followed by decline from 2.27 to 1.82 between 2008-2020(AAPC:-1.98; p<0.0001). Males had a higher AAMR(2.32) than females(1.69) but showed a lesser increase in mortality(AAPC:0.95;p=0.006) than females(AAPC:1.46;p<0.0001). Among races, non-Hispanic(NH) Blacks had the highest AAMR(3.07), followed by NH American Indians(2.54), NH Whites(1.89), Hispanics(1.57), and NH Asian(1.13). NH Blacks showed a decline in mortality(AAPC:-0.76;p=0.138) while NH Whites and Hispanics showed an increase in mortality(AAPC:1.66;p<0.0001 and AAPC:2;p=0.056, respectively). Geographically, AAMRs were highest in South(2.4). Northeast was the only census region which showed a decline in mortality(AAPC:-1.36;p=0.052). Region with greatest increase in mortality was West(AAPC:2.98;p<0.0001). Nonmetropolitan areas showed disproportionately higher mortality(AAMR:2.14) than metropolitan areas(AAMR:1.89). Additionally, between 1999-2020, nonmetropolitan areas showed higher increase in AAMR(AAPC:2.03;p<0.0001) compared to metropolitan areas(AAPC:1.15;p=0.004). Of 10-year age groups, all showed an overall increase in mortality between 1999-2020, with the greater increase seen for 45-54 years(AAPC:3.85;p<0.0001), followed by 55-64 years(AAPC:3.63;p<0.0001).

Conclusion

We found significant increase in sepsis-related mortality, though persistent disparities exist. Males, NH Black populations, residents of South and nonmetropolitan areas experienced disproportionately higher mortality rates.

Digital Object Identifier (DOI)