What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac arrhythmias and anemia. Primary outcome: Age-adjusted mortality rate for cardiac arrhythmia in anemic patients.

What question did this study set out to answer?

Examine long-term trends in mortality rates from cardiac arrhythmias among anemic adults in the US.

February 22, 2026Open Access

Mortality trends involving fatal-arrhythmias and anemia in the United States: A retrospective analysis of 25 years

Key Result

The age-adjusted mortality rate for cardiac arrhythmias in anemic adults in the US increased significantly from 2.30 in 1999 to 5.03 in 2023, with higher rates in men and rural areas.

Key Points

Examine long-term trends in mortality rates from cardiac arrhythmias among anemic adults in the US.
Retrospective observational study
Data sourced from CDC's Epidemiologic Research database
Used ICD-10 codes to identify conditions
Analyzed trends using Joinpoint Regression Program
Set significance at p-value < 0.05
Age-adjusted mortality rate for cardiac arrhythmias in anemic patients rose from 2.30 to 5.03 over 25 years
Higher mortality rates observed in males compared to females
Non-Hispanic White adults had the highest mortality rates among racial groups
Rural areas showed higher mortality rates than urban areas
Significant variation in mortality rates by geographic region, with the Midwest and South most affected.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

Population

Anemic adults in the United States from 1999 to 2023 identified via the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database using ICD-10 codes.

Outcome

Age-adjusted mortality rate associated with cardiac arrhythmiashard clinical

Mortality from cardiac arrhythmias in anemic adults in the US has more than doubled over the past 25 years, with significant disparities by sex, race, and rural versus urban setting.

Main Result

Absolute Event Rate: 5.03% vs 2.3%

Abstract

This study aims to examine long-term trends in age-adjusted mortality rate associated with cardiac arrhythmias among anemic adults in the United States from 1999 to 2023 and assess disparities by sex, race/ethnicity, geographic region, and urban–rural residence. For this retrospective observational study, the data was extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. International classification of disease (ICD)-10 codes were used to identify cardiac arrhythmia and anemia. We used Joinpoint Regression Program (V.5.4.0) for the analysis of trends and a P -value of <.05 was considered statistically significant. The overall age-adjusted mortality rate for cardiac arrhythmia in anemic patients increased from 2.30 in 1999 to 5.03 in 2023, showing a more than 2-fold rise over the 25-year period. Males consistently had a higher mortality than females, rising from 2.64 to 6.11 in men and from 2.09 to 4.28 in women between 1999 and 2023. Non-Hispanic (NH) White adults had the highest mortality, followed by NH Blacks or African American, Hispanics, and NH others respectively throughout 1999 to 2023. Highest mortality rates were observed in Rhode Island, West Virginia, Ohio, and Vermont. Rural areas had higher mortality than urban areas, rising from 2.52 to 5.63 compared with 2.24 to 4.14 in urban areas between 1999 and 2020. The highest mortality rates were in the midwest and south. In conclusion, mortality from cardiac arrhythmias in anemic adults has increased significantly over the past 25 years. There are disparities by sex, race, region, and rural versus urban setting that suggest the need for focused interventions and targeted policy design for vulnerable communities to avoid preventable deaths.