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Background <p>Acute Respiratory Failure (ARF) is a serious and often life-threatening condition and has become a significant cause of morbidity and mortality over the last two decades in the United States. In this study, we analysed the temporal trends of demographic and geographical differences in Acute Respiratory Failure-related mortality among patients in the USA.</p> Methods <p>Using the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, this study assessed ARF mortality data from 1999 to 2020 in all age groups. Age-adjusted mortality rates (AAMRs) per 1,000,000 and annual per cent changes (APC), along with 95% CI, were calculated through joinpoint regression analysis, and data were stratified by year, age, sex, race/ethnicity, geographical regions, urbanisation, states, and place of death.</p> Results <p>Between 1999 and 2020, 1,340,567 ARF-related deaths occurred among the population of all age groups. The overall AAMR increased from 55.8 in 1999 to 64.5 in 2005, followed by a sharp increase of 558.1 in 2020. Males consistently had higher AAMR than females from 1999 (AAMR males: 68.2 vs. female: 48) to 2020 (AAMR males: 682.4 vs. female: 461.2). NonHispanic (NH) American Indian or Alaska Native had the highest overall AAMR (231.1), followed by NH Black or African American (223.5), Hispanic or Latino (184.3), NH White (177), and NH Asian or Pacific Islander (133.1). AAMR also varied substantially by region, with the South having the highest AAMR (195.6), followed by the Midwest (184.5), the West (179.7) and the Northeast (152.4). Non-metropolitan areas had higher ARF-related AAMR (190.4) than metropolitan areas (179.7). Among the states, Kentucky had the highest AAMR (294.6), followed by South Carolina (284) and Indiana (276.4), while Maryland had the lowest AAMR (89.4) among the states. Most deaths (75.4%) occurred in inpatient medical facilities. Other common locations included nursing facilities (8.6%), home (7.1%), and the hospice centres (4.1%).</p> Conclusion <p>ARF mortality exhibited a clear pattern: an increase gradually from 1999 to 2005, followed by a sharp increase from 2005 to 2020. The highest AAMR were observed among male sex, NH American Indian or Alaska Native ethnicity, and among patients living in the south region and non-metropolitan areas. Targeted interventions are essential to reduce ARF mortality, especially among vulnerable populations.</p>

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Trends in mortality due to acute respiratory failure in the United States (1999–2020): A CDC WONDER database analysis

  • 期刊论文

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  • 发表日期：

    2025年11月8日

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  • Abdullah Nadeem,
  • Akash Kumar,
  • FNU Ram,
  • Ishwa Shakir,
  • Laiba Sultan,
  • Eaman Fatima,
  • FNU Riya,
  • Nisha Kumari

摘要

Background

Acute Respiratory Failure (ARF) is a serious and often life-threatening condition and has become a significant cause of morbidity and mortality over the last two decades in the United States. In this study, we analysed the temporal trends of demographic and geographical differences in Acute Respiratory Failure-related mortality among patients in the USA.

Methods

Using the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, this study assessed ARF mortality data from 1999 to 2020 in all age groups. Age-adjusted mortality rates (AAMRs) per 1,000,000 and annual per cent changes (APC), along with 95% CI, were calculated through joinpoint regression analysis, and data were stratified by year, age, sex, race/ethnicity, geographical regions, urbanisation, states, and place of death.

Results

Between 1999 and 2020, 1,340,567 ARF-related deaths occurred among the population of all age groups. The overall AAMR increased from 55.8 in 1999 to 64.5 in 2005, followed by a sharp increase of 558.1 in 2020. Males consistently had higher AAMR than females from 1999 (AAMR males: 68.2 vs. female: 48) to 2020 (AAMR males: 682.4 vs. female: 461.2). NonHispanic (NH) American Indian or Alaska Native had the highest overall AAMR (231.1), followed by NH Black or African American (223.5), Hispanic or Latino (184.3), NH White (177), and NH Asian or Pacific Islander (133.1). AAMR also varied substantially by region, with the South having the highest AAMR (195.6), followed by the Midwest (184.5), the West (179.7) and the Northeast (152.4). Non-metropolitan areas had higher ARF-related AAMR (190.4) than metropolitan areas (179.7). Among the states, Kentucky had the highest AAMR (294.6), followed by South Carolina (284) and Indiana (276.4), while Maryland had the lowest AAMR (89.4) among the states. Most deaths (75.4%) occurred in inpatient medical facilities. Other common locations included nursing facilities (8.6%), home (7.1%), and the hospice centres (4.1%).

Conclusion

ARF mortality exhibited a clear pattern: an increase gradually from 1999 to 2005, followed by a sharp increase from 2005 to 2020. The highest AAMR were observed among male sex, NH American Indian or Alaska Native ethnicity, and among patients living in the south region and non-metropolitan areas. Targeted interventions are essential to reduce ARF mortality, especially among vulnerable populations.