Retrospective analysis in mortality from phlebitis/thrombophlebitis and atrial fibrillation/flutter in u.S. adults aged ≥45 years from 1999–2023: A CDC wonder study

Acute Myeloid Leukemia and sepsis-related mortality in the United States (U.S.) older adults: Nationwide trends and disparities over 25 years (1999 – 2023)

Trends in comorbid mortality from disseminated intravascular coagulation and sepsis in United States adults: A population-based analysis using CDC wonder database

Temporal trends and demographic patterns in Hodgkin and non-Hodgkin lymphoma mortality among u.s. adults: A CDC wonder study

4583 Background: Patients in rural areas in the US often have worse healthcare outcomes due to socioeconomic deprivation, higher rates of smoking, and limited access to medical care. Despite a general decline in bladder cancer mortality over the past two decades, comprehensive studies comparing these trends between urban and rural mortality are scarce. Methods: Utilizing the CDC WONDER database, we extracted mortality data for bladder cancer from 2000 to 2020. Age-adjusted mortality rates per 100,000 persons were standardized to the Year 2000 US standard population. Data segmentation by urbanity utilized the 2013 National Center for Health Statistics Urban-Rural Classification Scheme. The National Cancer Institute's Joinpoint Regression Program was employed to calculate average annual percent changes (AAPCs) and annual percent changes (APCs). Results: In our analysis, we identified a total of 306,750 bladder cancer death cases from 2000 to 2020. Significant improvements in bladder cancer mortality were observed in urban areas, with large central metros experiencing the most pronounced decrease (AAPC -1.0%, p<0.001). This decline was moderate between 2000 and 2016 (APC -0.3, p< 0.001) but accelerated between 2016 and 2020 (APC -3.8%, p<0.001). Large fringe and medium metros also saw comparatively smaller but significant declines (AAPC -0.6%, P<0.05) and also accelerated between 2016-2020. In contrast, small metro and rural areas (micropolitan and noncore) showed no significant improvement, with mortality rates remaining stable between 2000 and 2020 (AAPC 0.2%, P=0.099). Conclusions: This analysis, the largest to date comparing urban and rural mortality trends in bladder cancer, highlights significant disparities in outcomes between large urban and rural areas. The marked improvement in urban areas, especially noted around the time novel agents such as immunotherapy were introduced, underscores the potential impact of advanced treatments. However, the stable mortality rates in rural areas suggest that access to advanced care, environmental influences, socioeconomic status, and slower adaptation of new guidelines in rural settings may play critical roles. These findings underline the urgent need for strategies to close the urban-rural gap. [Table: see text]

Background: Sleep apnea is a major risk factor for ischemic heart disease (IHD), and the two conditions are closely related. Our study aims to examine mortality trends related to IHD from 1999 to 2020, exploring potential contributions of sleep apnea to disparities across demographic and geographic subgroups. Method: Data related to mortality was extracted from CDC WONDER. The analysis of Multiple Cause of Death Files was conducted from 1999 to 2020 to identify fatalities associated with ischemic heart disease and sleep apnea. Crude rates and age-adjusted mortality rates (AAMRs) per 100,000 populations were calculated for variables including age, gender, race, and geographic regions. Joinpoint regression analysis was utilized to evaluate annual percent changes (APCs) and average annual percent changes (AAPCs). Results: Overall, the AAPC for IHD mortality was 9.15% (p<0.0001) from 1999 to 2020, with notable increases noted between 1999 and 2008 (APC=12.62%, 95% CI: 11.05–14.62) and 2018 and 2020 (APC=12.50%, 95% CI: 6.81–15.65). In comparison to females (8.99%, 95% CI: 8.57–9.78), males had a higher AAPC (9.24%, 95% CI: 8.78–9.83). There were clear racial inequalities, with Whites showing steady increases during the study period (AAPC=9.39%, 95% CI: 8.98–9.85) and Black or African Americans having a rapid increase in 2018–2020 (APC=23.54%, 95% CI: 14.05–29.43). Geographically, the Midwest reported the highest AAPC (10.07%, 95% CI: 9.37–11.86). Both AAMR and crude rates reflected these patterns, with crude rates rising from 0.36 in 1999 to 2.34 in 2020, mirroring the increase in AAMR. Older age groups and populations with higher sleep apnea prevalence exhibited elevated mortality burdens. Conclusion: The findings highlight persistent disparities in IHD mortality, potentially exacerbated by sleep apnea. These statistics underscore the growing impact of IHD and emphasize the need for targeted interventions addressing both IHD and sleep apnea to reduce persistent disparities.

National temporal trends and demographic disparities in primary immunodeficiency-related mortality in the United States, 1999–2024

Advances in cancer research and treatment access have led to decreasing cancer mortality in the US; however, cancer remains the leading cause of death among Hispanic individuals. To evaluate longitudinal cancer mortality trends from 1999 to 2020 among Hispanic individuals by demographic characteristics and to compare age-adjusted cancer death rates between the Hispanic population and other racial and ethnic populations during 2000, 2010, and 2020. This cross-sectional study obtained age-adjusted cancer death rates among Hispanic individuals of all ages between January 1999 and December 2020, using the Centers for Disease Control and Prevention WONDER database. Cancer death rates in other racial and ethnic populations were extracted for 2000, 2010, and 2020. Data were analyzed from October 2021 to December 2022. Age, gender, race, ethnicity, cancer type, and US census region. Trends and average annual percent changes (AAPCs) in age-adjusted cancer-specific mortality (CSM) rates among Hispanic individuals were estimated by cancer type, age, gender, and region. From 1999 to 2020, 12 644 869 patients died of cancer in the US, of whom 690 677 (5.5%) were Hispanic; 58 783 (0.5%) were non-Hispanic American Indian or Alaska Native; 305 386 (2.4%), non-Hispanic Asian or Pacific Islander; 1 439 259 (11.4%), non-Hispanic Black or African American; and 10 124 361 (80.1%), non-Hispanic White. For 26 403 patients (0.2%), no ethnicity was stated. The overall CSM rate among Hispanic individuals decreased by 1.3% (95% CI, 1.2%-1.3%) annually. Overall CSM rate decreased more for Hispanic men (AAPC, -1.6%; 95% CI, -1.7% to -1.5%) compared with women (AAPC, -1.0%; 95% CI, -1.0% to -0.9%). While death rates among Hispanic individuals decreased for most cancer types, mortality rates for liver cancer (AAPC, 1.0%; 95% CI, 0.6%-1.4%) increased among Hispanic men, and rates of liver (AAPC, 1.0%; 95% CI, 0.8%-1.3%), pancreas (AAPC, 0.2%; 95% CI, 0.1%-0.4%), and uterine (AAPC, 1.6%; 95% CI, 1.0%-2.3%) cancers increased among Hispanic women. Overall CSM rates increased for Hispanic men aged 25 to 34 years (AAPC, 0.7%; 95% CI, 0.3%-1.1%). By US region, liver cancer mortality rates increased significantly in the West for both Hispanic men (AAPC, 1.6%; 95% CI, 0.9%-2.2%) and Hispanic women (AAPC, 1.5%; 95% CI, 1.1%-1.9%). There were differential findings in mortality rates when comparing Hispanic individuals with individuals belonging to other racial and ethnic populations. In this cross-sectional study, despite overall CSM decreasing over 2 decades among Hispanic individuals, disaggregation of data demonstrated that rates of liver cancer deaths among Hispanic men and women and pancreas and uterine cancer deaths among Hispanic women increased from 1999 to 2020. There were also disparities in CSM rates among age groups and US regions. The findings suggest that sustainable solutions need to be implemented to reverse these trends among Hispanic populations.

Trends in mortality from deep vein thrombosis and pulmonary embolism as multiple causes of death in u.S. adults aged ≥65 years (1999–2023): A CDC wonder analysis

Mortality trends in multiple sclerosis and cardiovascular disease in adults in the United States: A 25-year mortality perspective.

Objective: To analyze the level and trend of respiratory disease mortality in China from 2002 to 2016. Methods: The standardized mortality rates were calculated based on the China health statistics yearbook (2003-2012) and China statistical yearbook of health and family planning (2013-2017) data released by the statistical information center of National health Commission of the People's Republic of China. Joinpoint model was used to calculate the standardized mortality rates (SMR), Annual percentage change (APC) and the average annual percentage change (AAPC) for standardized mortality rates. Results: The SMR of respiratory diseases and chronic lower respiratory diseases were decreased significantly in 2002 to 2016 (AAPC=-3.6%, AAPC=-6.4%, P<0.001, respectively). The SMR of lung cancer showed a significant increase trend (AAPC=1.6%, P=0.001). There were no significant differences in the SMR of pneumonia and pneumonoconiosis (APCC=1.0%, P=0.242; APCC=-0.2%, P=0.905). Both urban and rural SMR of respiratory diseases were declining significantly (AAPC=-2.9%, P=0.001; AAPC=-4.2%, P<0.001). Both urban and rural SMR of lung cancer showed an increasing trend (AAPC=0.6%, P=0.022; AAPC=2.1%, P=0.003, respectively). The SMR of pneumonia in urban areas showed an upward trend (AAPC=2.7%, P=0.017). The SMR of respiratory disease of all age groups (<35 years old, 35-65 years old and ≥65 years old) showed a downward trend (AAPC=-3.8%, P=0.001; AAPC=-2.6%, P<0.001; AAPC=-3.9%, P<0.001). The SMR of pneumonia between 35 and 65 years old and SMR of lung cancer over 65 years old showed an increasing trend (AAPC=2.8%, P=0.001; AAPC=2.4%, P<0.001). The SMR of respiratory diseases among males and females showed a downtrend (AAPC=-3.1%, P<0.001; AAPC=-4.3%, P<0.001). However, the SMR of lung cancer in males and females increased significantly (AAPC=1.2%, P<0.001; AAPC=2.5%, P<0.001, respectively). There were no significant trends in the SMR of pneumonia and pneumoconiosis in males (AAPC=1.5%, P=0.096; AAPC=-1.6%, P=0.218). There was no obvious trend in the SMR of pneumonia in females (AAPC=-0.1%, P=0.872). Conclusions: The SMR of respiratory diseases in China generally shows a downward trend. The overall SMR and SMR of major respiratory diseases varies among different regions, genders and age groups.

e19567 Background: At diagnosis, around 20% of patients with multiple myeloma (MM) have impaired renal function. Renal failure (RF) is the leading cause of death in these patients, particularly among older adults. Despite the established correlation, mortality trends across various demographics in the United States is underexplored. This study examines mortality trends and discrepancies in MM and RF among older adults aged 55 and above from 1999 to 2020. Methods: Using the ICD-10 codes C90.0 (Multiple myeloma - Malignant neoplasms) and N17-N19 (Renal failure), we extracted crude mortality rate (CMR), and age adjusted mortality rate (AAMR) from CDC WONDER, stratified by gender, age, race, geographic areas, and urban/rural status from 1999 to 2020. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage changes (AAPC). Results: A total of 49043 deaths were reported throughout the study period, with an overall AAMR of 3.11. A variable trend in mortality was observed, with an increasing trend from 1999 to 2003 (APC: 2.31) followed by a significantly decreasing trend from 2003 to 2020 (APC: -3.03;). The AAMR for males was double that of females (4.14 vs. 2.35), plus the rate of decline was less pronounced for males (AAPC: -1.80) than females (AAPC: -2.47). Non-Hispanic (NH) Blacks have the highest AAMR (6.89) and NH Asians the lowest (1.61). However, NH Whites showed the slowest rate of decline (AAPC -1.91). Geographically, the Midwest had the highest AAMR (3.24). Rural areas had slightly higher AAMRs than urban areas (3.17 vs. 3.06). The District of Columbia had the highest AAMR of 5.29. Most deaths occurred in medical facilities (55.51%). Lastly, the age group 85+ years old showed the highest CMR of 7.16 (AAPC= -0.74). Conclusions: Although there has been an overall decline in mortality related to MM and RF, the rate of decline has slowed in recent years. Higher AAMR was observed in males, the Midwest, the District of Columbia, rural areas, Black or African Americans, and geriatric age groups, indicating a need for targeted interventions in these groups to mitigate fatalities caused by MM and RF. Variable Variable Deaths (n) Total AAMR (95% CI) Deaths (n) Total AAMR (95% CI) Overall 49043 3.11 (3.08 to 3.14) Urbanization Sex Urban 40117 3.06 (3.03 to 3.09) Female 21313 2.35 (2.32 to 2.38) Rural 8926 3.17 (3.11 to 3.24) Male 27730 4.14 (4.09 to 4.19) Race/Ethnicity Census Region NH American Indians 256 3.12 (2.72 to 3.52) Northeast 9267 2.99 (2.93 to 3.05) NH Asians 960 1.61 (1.50 to 1.71) Midwest 11408 3.24 (3.18 to 3.30) NH Blacks 9746 6.89 (6.75 to 7.03) South 17961 3.07 (3.03 to 3.12) NH White 35092 2.77 (2.74 to 2.80) West 10407 3.07 (3.01 to 3.13) Hispanics 2906 2.57 (2.48 to 2.67)

Background: Kidney cancer remains a significant contributor to cancer-related morbidity and mortality. Current projections estimate that the annual incidence will reach approximately 475,000 new cases by 2030. Furthermore, cardiovascular disease (CVD) is emerging as a leading non-cancer cause of death among kidney cancer patients, who face a nearly threefold higher risk of CVD-related mortality.This study aims to evaluate the shifting mortality landscape by examining the impact of CVD on overall mortality in patients with kidney cancer. Methods: A retrospective analysis of CVD-related mortality in kidney cancer patients was conducted using the CDC WONDER database from1999 to 2020. Age-Adjusted Mortality Rates (AAMRs) per 100,000 and Annual Percent Change (APCs) with 95% CIs were determined. Joinpoint regression analysis was employed to examine trends across various demographic and regional groups. Results: A total of 106,320 CVD-related mortality occurred in kidney cancer patients from 1999 to 2020, with 35.11% deaths occurring at the Decedent’s home. With an AAPC (Average Annual Percent Change) of 0.44 (95% CI: 0.23 to 0.72] the overall AAMR increased from 1.38 in 1999 to 1.58 in 2020. There was an upward trend between 1999 and 2006 (APC:0.71 CI: 0.01 to 2.96) followed by a downward trend till 2016 (APC:-0.85 CI:-2.82 to -0.43) followed by a significant increase till 2020 (APC:3.29 CI:1.69 to 6.49). Males consistently had higher AAMRs than females (2.19 vs 0.88). AAMRs differed markedly by race, with the highest rate among NH-American Indian or Alaska Native (1.95), followed by NH-Black or African American (1.58), NH-White (1.43), Hispanic (1.38), and the lowest in NH-Asian or Pacific Islander (0.74). The greatest rise in mortality was observed in NH-Black or African American from 2018-2020 (APC:6.17 CI:-0.66 to 10.36). 35-44 year age group had an overall rise from 1999-2020 (APC:1.04 CI:-0.03 to 2.18). Nonmetropolitan areas had the greatest increase from 1999-2020 (AAPC:1.39). Rhode Island, North Dakota, California, Oklahoma, Mississippi, and Nebraska exhibited AAMRs nearly twice as high as those in states within the lowest 10th percentile. Conclusion: CVD-related mortality among kidney cancer patients presents with a concerning upward trend, with persistent demographic and geographic disparities. These trends further necessitate an integrated cardio-oncology approach to improve survival outcomes associated with two of the leading causes of death.

e18601 Background: Myeloproliferative neoplasms (MPNs) are a group of hematologic malignancies associated with substantial morbidity and mortality. Understanding long-term mortality trends is crucial for guiding healthcare strategies and assessing the impact of advancements in diagnosis and treatment. Methods: Mortality data, including age-standardized morality rate, for MPNs in the United States from 1990 to 2019 were obtained from the Global Burden of Disease database. Temporal trends were analyzed using Joinpoint regression analysis by calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: Total Mortality: An estimated total of 222,511 MPN-related deaths were reported from 1990 to 2019. Overall Trends: MPN-related mortality exhibited an overall increasing trend (AAPC: 0.102, 95% CI: 0.067 to 0.133; p &lt; 0.001). Mortality initially rose during 1990 to 2001 (APC: 0.67; p = 0.0004), followed by a decline from 2001 to 2004 (APC: -1.02; p = 0.037), and a subsequent increase from 2004 to 2011 (APC: 0.80; p = 0.037). A stabilization phase occurred from 2011 to 2015 (APC: -0.45; p &gt; 0.05), followed by a significant decline from 2015 to 2019 (APC: -1.44%; p &lt; 0.001). Gender-Specific Trends: Females: Mortality rates initially increased (APC: 0.85 from 1990 to 2001; p &lt; 0.001), followed by declines from 2001 to 2004 (APC: -1.17%; p &lt; 0.001) and fluctuations in subsequent years, with a final significant decline from 2016 to 2019 (APC: -1.91; p &lt; 0.001). The overall AAPC for females was 0.053%, which was not statistically significant (p = 0.323). Males: Mortality rates noticed an initial increase in the early 1990s (APC: 0.90 from 1990 to 1994; p &lt; 0.001), followed by a stabilization 1994 to 2001 (APC: 0.04; p &gt; 0.05), and then rose again from 2001 to 2005 (APC: 1.01; p &lt; 0.001) and 2005 to 2010 (APC: 1.34; p &lt; 0.001). A significant decline followed from 2014 to 2019 (APC: -1.46; p &lt; 0.001), with an overall AAPC of -0.07% (95% CI: -0.108 to -0.032; p &lt; 0.05). Conclusions: Over the last three decades, MPN-related mortality in the United States has demonstrated an initial increase followed by periods of stabilization and significant declines, particularly after 2014. Both males and females experienced mortality reductions in recent years, likely reflecting advancements in therapeutic strategies and improved disease management. Further investigations into gender-specific and global trends may provide additional insights into optimizing treatment and care for MPN patients.

Introduction: The need for increased utilization of hospice in the dying patients has been recognized in multiple fields including cardiology recently. The aim of this study to examine the trends in location of deaths in acute myocardial infarction (AMI) related deaths in the United States from 2003 to 2019. Methods: The CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) was used to access the National Vital Statistics System data from 2003 to 2019. AMI related deaths in patients ≥ 25 years of age were identified from multiple causes of death. Joinpoint regression was used to examine changes in trend, annual percentage change (APC), and average annual percentage change (AAPC). Location of death was categorized as home, medical facility, hospice facility, nursing home/long term care (NH/LTC) and other/unknown. Results: Of AMI related deaths, 23.62% occurred at home, 0.94% at hospice facility, 39.64% at medical facility and 13.30% at NH/LTC. From 2003-2019, the number of deaths has increased at hospice facility (AAPC 24.7[95% CI, 18.1 to 31.6]) and decreased at both medical facilities (AAPC -3.1[95% CI, -3.5 to -2.8]) and NH/LTC (AAPC -4.3[95% CI, -4.6 to -3.9]). The number of deaths initially decreased at home till 2009 (APC -1.9[95% CI, -2.5 to -1.3]) followed by increase till 2019 (APC 1.5[95% CI, 1.2 to 1.8]). Conclusion: Although there was an increasing trend in AMI related mortality at hospice and home locations, rates of utilization of hospice facility remain very low.

Multiple Myeloma Mortality Trends and Racial Disparities in the United States and Texas: A 20-Year Study (1999-2020): CDC Wonder Database