Trends and disparities in disseminated intravascular coagulation-related mortality among adults aged 25 and above in the U.S., 1999–2020: CDC WONDER insights

Abstract Background Disseminated intravascular coagulation (DIC) is a severe, life-threatening coagulopathy often secondary to infection, malignancy, or obstetric complications. Despite advances in critical care, national patterns and disparities in DIC-related mortality remain underexplored. Objectives To examine temporal, demographic, and regional trends in DIC-related mortality among U.S. adults from 1999 to 2020. Methods Death certificate data were obtained from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database for adults aged ≥ 25 years with DIC listed as an underlying or contributing cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percent change (APC) were calculated using Joinpoint regression and stratified by sex, race/ethnicity, age group, urbanization, and region. Results From 1999 to 2020, 71,241 DIC-related deaths were identified among U.S. adults. The overall AAMR declined from 2.1 per 100,000 in 1999 to 1.6 in 2020. Men had higher mortality than women (1.6 vs. 1.5), and non-Hispanic (NH) Black adults had the highest AAMR (2.8), followed by Hispanic (1.6), and NH White adults (1.4). Mortality was highest among adults ≥ 85 years (6.1), residents of nonmetropolitan areas (1.6), and those in the South (1.6) and Northeast regions (1.5). Conclusions Following a prolonged decline, DIC-related mortality in U.S. adults has risen since 2017, particularly among men, Black adults, and those in the South and rural areas. Targeted prevention and equitable access to critical care are essential to curb this resurgence.