S3030 Trends in Mortality Due To Acute Intestinal Infections in US Adults: A CDC Analysis (1999-2020)

Introduction: Acute intestinal infections are a common and serious medical emergency among adults in the United States. This study investigates mortality trends and variations from 1999 to 2020. Methods: Mortality data from the CDC WONDER database (1999–2020) were analyzed retrospectively. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, and trends assessed using Average Annual Percent Change (AAPC) and Annual Percent Change (APC). Data were stratified by age, sex, race/ethnicity, and geographic region. Results: Between 1999–2020, 253,910 deaths due to acute intestinal infections occurred. Most deaths were in inpatient facilities (68.8%), nursing homes/long-term care (15.4%), homes (7.1%), hospices (4.2%), emergency/outpatient settings (2.2%), “dead on arrival” (0.1%), and unknown locations (0.2%). Mortality rates rose significantly for both sexes. Males had an AAPC of 6.96% (95% CI: 5.08–8.88; P < 0.000001), with sharp increases from 1999–2006 (APC: 28.4%), moderate rise until 2011 (APC: 6.5%), and decline thereafter (APC: –7.48%). Females had an AAPC of 6.59% (95% CI: 4.79–8.43; P < 0.000001), with an early surge (1999–2005: APC 24.0%) and post-2011 decline (APC: –7.48%). All racial/ethnic groups saw increases. American Indian/Alaska Native adults had the steepest rise (AAPC: 11.17%; 1999–2006 APC: 32.7%). Hispanic adults followed (AAPC: 9.39%) with early surge and later stabilization. Other increases: Asian/Pacific Islander (6.80%), Black/African American (6.70%), and White (6.52%). Regionally, the South had the fastest growth (AAPC: 9.05%), then Midwest (8.01%), West (5.88%), and Northeast (5.32%) (P < 0.000001 for all). Nonmetro areas were most affected: micropolitan/non-core (AAPC: 9.53%) and other nonmetro areas (9.24%). In metros, medium metros rose fastest (7.95%), then large fringe metros (6.58%). By age, mortality rose across all groups. Young adults (25–44 years) had an AAPC of 7.00%, driven by pre-2012 increases (APC: 9.48%). Middle-aged adults (45–74 years) had highest AAPC (7.33%), early spike (APC: 16.0%), later plateau/decline. For those ≥75 years, AAPC was 6.54%, sharp post-2011 drop (APC: 7.91%). Conclusion: This study reveals substantial disparities in mortality from acute intestinal infections across demographic and geographic groups in the U.S., emphasizing the need for targeted public health efforts to reduce these inequities and improve outcomes in underserved populations.