P177 Double jeopardy: escalating mortality trends and disparities in lung cancer patients with sepsis – a retrospective epidemiological study

Abstract

<h3>Background</h3> Lung cancer (LC) remains the leading cause of cancer-related mortality globally. Studies indicate LC patients with sepsis have significantly lower survival rates, yet the temporal trends and disparities in mortality remain unexplored. We examined mortality trends and disparities of LC complicated by sepsis across different sociodemographic strata. <h3>Methods</h3> This retrospective study analysed death certificate data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research database from 1999–2023, for individuals ≥25 years with multiple causes of death listed as lung/bronchus cancer (ICD-10: C34) with sepsis. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, race/ethnicity, and geographic region, with Joinpoint regression analysis to determine the change in mortality trends. <h3>Results</h3> From 1999–2023, 103,907 deaths were attributed to LC with co-existing sepsis, demonstrating increasing mortality trends throughout the study period. AAMRs rose significantly from 1.61 in 1999 to 2.07 in 2023 (AAPC: 1.32%; p&lt;0.000001). Sex-stratified analysis revealed men had consistently higher overall AAMRs (2.32/100,000) with an AAPC of 0.49% (95% CI: -0.12 to 1.12; p=0.12) compared to women (1.37/100,000) with an AAPC of 1.94% (95% CI: 1.74 to 2.14; p&lt;0.000001). Patients aged ≥65 years exhibited the highest mortality rates (6.59%). Racially, non-Hispanic (NH) Black individuals had the highest overall AAMRs with increasing mortality patterns (AAMRs: 2.57/100,000; AAPC: 0.32%; 95% CI: 0.045 to 0.599; p=0.02), while Hispanic populations recorded the lowest AAMR (1.01/100,000; AAPC: 0.61%; 95% CI: 0.156 to 1.068; p=0.01). Regionally, the South demonstrated the highest mortality (AAMRs: 2.04), followed by the Northeast (AAMRs: 1.78), Midwest (AAMRs: 1.75), and West (AAMRs: 1.42). Most deaths occurred in inpatient medical facilities (90,425 deaths; 87%). <h3>Conclusion</h3> Mortality rates increased significantly over the study period with a significant increase during recent years. Notable disparities across sex, race/ethnicity, and geographic regions were observed, with NH Black populations and Southern states showed highest mortality rates. These findings highlight the urgent need for targeted sepsis prevention protocols in LC patients, enhanced surveillance systems for high-risk demographics, and comprehensive region-specific interventions to address underlying healthcare disparities and improve clinical outcomes across all populations.