Abstract A021: National Trends in Stroke Mortality Associated with Sepsis in the United States,1999-2023.

Introduction: Sepsis is an emerging factor in stroke mortality, reflecting systemic inflammation and cerebrovascular vulnerability. With an aging population and more post-sepsis complications, understanding this connection is crucial for guiding stroke prevention efforts. This study analyzes over twenty years of national mortality data to identify trends over time in cases where both sepsis and stroke contributed. By exploring this, we aim to stress the importance of integrated strategies that address infectious triggers of neuroinflammation within stroke care systems in the United States. Methodology: Mortality data from CDC WONDER (1999–2023) were analyzed for deaths involving sepsis (ICD-A40-A41) and cerebrovascular disease (I60-I69) in adults aged 65 and over. Age-adjusted mortality rates per million were calculated using the 2000 U.S. standard population. Join point regression evaluated temporal trends, estimating annual and average annual percent changes (APC and AAPC) with 95% CIs. An AI grammar check was used in all written materials. Results: From 1999 to 2011, stroke-related sepsis mortality decreased significantly (AAMR: 30.39 to 16.38; APC: -5.44; 95% CI: -5.98 to -4.90), then increased again until 2023 (AAMR: 19.39; APC: 2.15; 95% CI: 1.59 to 2.71). Males consistently had higher mortality rates than females (22.87 vs. 16.72 in 2023). Racial and ethnic disparities persisted, with non-Hispanic (NH) Blacks/African Americans showing the highest average AAMR, followed by NH American Indians/Alaska Natives, Hispanics, and NH Whites. Geographically, the South experienced the highest mortality rate, and rural areas had higher overall AAMR compared to urban areas (19.99 vs. 19.67). Conclusion: Despite early progress, the recent increase in stroke-related deaths among septic patients, especially among males, Black populations, and in the southern and western regions, highlights ongoing epidemiological disparities. These trends emphasize the need for comprehensive clinical protocols that incorporate stroke risk management into sepsis treatment, along with targeted public health initiatives to address regional and racial inequities in health outcomes.