Background: COPD is the third leading cause of mortality worldwide. CKD is a major healthcare concern that commonly coexists with COPD, increasing morbidity and mortality of both conditions. Methods: Utilizing data from the CDC WONDER database, COPD and CKD-related deaths from 1999 to 2020 were identified. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were determined, using ICD-10 codes J40-44 and N18 for COPD and CKD, respectively. Joinpoint regression was used to analyze trends and annual percentage change (APC) variations for deaths stratified by year, sex, and geographical groups. Results: From 1999 to 2020, 172,439 COPD and CKD-related deaths were identified. Most occurred in inpatient medical facilities (44%), followed by nursing homes/long-term care facilities (23.6%), decedent’s homes (23.4%), and hospice/outpatient/ER facilities (5.5% each). Overall, AAMRs increased from 1999 to 2020 (APC 3.82). Males had higher AAMRs (27.49) than females (13.38), although the rise was more significant in females. When stratified by race, there was a consistent rise in AAMRs across all groups. Most notably, NH American Indian/Alaska Natives had the greatest increase in AAMR (21.05), while NH Asian/Pacific Islanders had the least (8.83). Non-metropolitan areas had greater AAMRs than in urban areas (23.21 vs. 17.87). AAMRs also varied regionally: Midwest (28.43), South (23.49), West (22.44), and Northeast (21.62). States in the upper 90th percentile of COPD & CKD-related deaths included West Virginia, North Dakota, Kentucky, Vermont, and Indiana, which had four times the AAMRs of states in the lower 10th percentile. Conclusion: The consistently rising mortality rate in COPD and CKD patients raises an important need to be explored. Persistent disparities exist, particularly among NH American Indian/ Pacific Islander males and individuals in the Midwest and rural areas, highlighting the need for targeted interventions for vulnerable groups and regions.

Background: Sepsis and liver disease represent significant and intersecting public health challenges, yet trends in sepsis-related mortality among individuals with liver disease remain poorly characterized. This study examines national mortality trends from 1999 to 2020, evaluating disparities by sex, race/ethnicity, and geographic location. Methods: Using CDC WONDER data, we analyzed age-adjusted mortality rates (AAMRs) for sepsis-related deaths among individuals with liver disease (ICD-10 codes K70-K76 and A40-A41). Joinpoint regression identified temporal trends, and annual percent change (APC) quantified rate variations. Analyses were stratified by sex, race/ethnicity, urbanization level, and census region. Results: Mortality rates showed a significant nationwide increase, particularly accelerating after 2009. Disparities emerged across demographic groups, with American Indian/Alaska Native populations experiencing the highest mortality rates overall, while Black/African American communities saw alarming late-period surges. Geographic patterns revealed particular challenges in rural areas and Midwestern states, where mortality rates climbed most steeply. Urban-rural divides widened over time, with non-metropolitan areas eventually surpassing urban mortality rates. Sex-based differences persisted, with males maintaining higher baseline mortality but females experiencing faster rate increases in recent years. These patterns suggest evolving epidemiological challenges that disproportionately affect certain populations and regions. The findings highlight the complex interplay between clinical, geographic, and socioeconomic factors influencing outcomes for this vulnerable patient population. Conclusions: Sepsis-related mortality among individuals with liver disease has risen markedly, with inequitable burdens across demographic and geographic subgroups. The findings underscore the need for targeted interventions addressing systemic disparities in healthcare access, social determinants, and clinical management.