Trends and disparities in acute respiratory distress syndrome-related mortality in the United States, 1999-2020: a CDC WONDER database analysis.

Background: Acute respiratory distress syndrome (ARDS) remains a concern for public health in the United States, with demographic groups being affected disproportionately in terms of mortality. The aim of this study is to describe national trends in mortality related to ARDS from 1999 to 2020 and to identify regional and demographic disparities. Methods: Data for mortality caused by ARDS in adults aged ≥ 25 were extracted from the CDC WONDER database from 1999 to 2020 using ICD-10 code J80. Age-adjusted mortality rates (AAMRs) per 100 000 and annual percent change with 95% confidence intervals were calculated and arranged by year, race, sex, urbanization, and census region. Results: Between the years 1999 and 2020, 263 648 ARDS-related deaths occurred among individuals aged ≥ 25. There was a moderate decline in AAMR from 7.4 to 4.2 between 1999 and 2018, followed by a sharp increase from 2018 onward, reaching 19.2. The overall AAMR for males was 6.7, and for females, it was 4.7. The highest racial disparities were observed among Non-Hispanic (NH) American Indian or Alaska Native individuals, who had an AAMR of 8.7, while the lowest AAMR was among NH Asian or Pacific Islander individuals, at 5.1. AAMRs also varied geographically, with the highest rates being recorded in the South and notable increases observed in nonmetropolitan areas. Conclusion: This study showed a significant rise in ARDS-related mortality among males, Non-Hispanic (NH) American Indians or Alaska Natives, residents of the South, and nonmetropolitan residents. While significant progress has been made in reducing mortality rates, challenges remain that require continued action.