Abstract Purpose This study aimed to analyze mortality trends among patients with pneumonia and chronic kidney disease in the United States from 1999 to 2020. By examining patterns across urbanization levels, racial and ethnic groups, geographic regions, and sex, the study sought to identify significant changes over time and potential disparities in mortality outcomes. Methods Mortality data were extracted from the CDC WONDER database for patients diagnosed with pneumonia (ICD-10: J09-J18) and chronic kidney disease (ICD-10: N18). Trends were analyzed using Annual Percent Change (APC) with 95% confidence intervals (CI). Joinpoint regression was utilized to identify significant shifts in mortality trends over time. The analysis was stratified by urbanization level (Large Central Metro, Large Fringe Metro, Medium Metro, Small Metro, Micropolitan), ethnicity (American Indian or Alaska Native, Asian or Pacific Islander, Black or African American, White), census region (Northeast, Midwest, South, West), Hispanic origin (Hispanic or Latino, Not Hispanic or Latino), and sex (Female, Male). Results From 2018 to 2020, significant increases in mortality were observed across all demographic and geographic categories. Urban areas, particularly Large Central Metro (APC = 39.4026%, p = 0.0008) and Small Metro (APC = 37.0284%, p = 0.0004), experienced the most pronounced rises. Ethnic disparities were evident, with Black or African American (APC = 49.9199%, p 0.000001) and Hispanic or Latino (APC = 61.5742%, p 0.000001) populations showing the highest mortality increases. By census region, the Midwest (APC = 35.7843%, p = 0.0004) and South (APC = 34.7972%, p = 0.0016) had the most significant spikes. Both females (APC = 36.0664%, p = 0.0004) and males (APC = 35.1504%, p 0.000001) experienced substantial mortality increases, with females showing slightly higher rates. Conclusion The findings reveal significant increases in mortality from 2018 to 2020 across all analyzed categories, with notable disparities among racial, ethnic, and geographic groups. These trends highlight the need for further investigation into underlying causes and targeted interventions to address inequities. Clinical implications The results underscore the importance of addressing disparities in healthcare access and outcomes, particularly for Black or African American and Hispanic or Latino populations. Clinicians should focus on early diagnosis, effective management of comorbidities, and equitable resource distribution to mitigate mortality risks in high-risk groups. This abstract is funded by: None
Chinnamuthu et al. (Fri,) studied this question.