4-023 Trends and disparities in atrial fibrillation and sepsis related mortality among adults in the united states: a CDC wonder databse analysis (1999–2023)
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Authors
Sheikh, Amna-Naveed
Issue Date
2025
Type
Article
Language
en
Keywords
atrial fibrillation , sepsis , mortality
Alternative Title
Abstract
Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia associated with increased morbidity and mortality, particularly in critically ill patients. Sepsis further exacerbates this risk, contributing to adverse cardiovascular (CVD) outcomes. This study aims to analyze AF-related mortality trends in sepsis patients in the United States from 1999 to 2023. Methods Trends in AF and sepsis-related mortality among adults aged 25 years from 1999 to 2023 were analyzed using the CDC WONDER multiple-cause of death database. Age adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race, census region and urbanization status.
Results: From 1999 to 2023, a total of 241,127 deaths related to AF and sepsis occurred among adults aged 25 years and older in the United States. The AAMR rose sharply from 2.02 in 1999 to 5.60 in 2018 (APC: 5.53*; 95% CI: 4.78 to 6.03; p = 0.0004), followed by a further increase to 7.87 in 2021 (APC: 12.63*; 95% CI: 8.33 to 14.96; p = 0.0004). After 2021, the AAMR remained stable through 2023. In 2023, males (8.54) averaged a considerably higher AAMR than females (6.05). Among racial groups, the highest AAMR in 2023 was reported in the Non-Hispanic (NH) White group (7.57), followed by the NH Black group (7.09), the Hispanics and Latinos (5.18) and the NH Others group (NH Asians and NH Native American Indian or Alaskan Native) at 4.45. Overall from 1999 to 2020, rural areas (3.87) averaged a significantly higher AAMR than urban areas (3.80). Regionally, in 2023, the Southern region averaged the highest AAMR at 7.93, followed by the West at 7.53, the Northeast at 6.15 and lastly the Midwest at 6.11.
Conclusion: AF-related mortality in sepsis patients has risen significantly over the past two decades, with notable disparities based on sex, race, and geographic region. The sharp increase in AAMR, particularly after 2018, highlights the need for targeted interventions to mitigate mortality risks in high-risk populations.
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Citation
Mesmar A, Thirupathy U, Warsi T, et al (2025). '4-023 Trends and disparities in atrial fibrillation and sepsis related mortality among adults in the united states: a CDC wonder databse analysis (1999–2023)', Heart, 111 (A137-A138)
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Journal
Heart