(271) Mortality From Medical and Surgical Complications of Care in the United States: Two-Decade Analysis

Introduction: Complications of medical and surgical care are critical healthcare issues, impacting important patient outcomes. Understanding mortality trends related to these complications is essential for improving the quality of care. In this study, we aim to investigate mortality associated with complications of medical and surgical care in the US.

Methods: We used the CDC's multiple causes of death data files to study mortality rates from medical and surgical complications of care from 1999 to 2020 in the US. Age-standardized mortality rates (ASMRs) per 100,000 population were analyzed using ICD codes T80-88. Joinpoint regression analysis was performed to report time trends and average annual percentage change (AAPC). Data were stratified by race, sex, and urbanization.

Results: A total of 20,709 deaths occurred in 1999, which fell to 12,662 deaths in 2020 (-38.9%). Analysis of temporal trends showed a significant decline in ASMR for both males (9.39 per 100,000 [9.21-9.57] in 1999 to 3.82 [3.73-3.91] in 2020, AAPC -4.4, p< 0.001) and females (6.25 [6.13-6.38] in 1999 to 2.59 [2.52-2.66] in 2020, AAPC -4.5, p< 0.001). All races saw large declines, with Asian and Pacific Islanders noting the greatest percentage decline (4.69 [4.16-5.23] in 1999 to 1.48 [1.32-1.64] in 2020, AAPC -4.7, p< 0.001). African Americans had the highest ASMR in 1999 and saw the greatest absolute decline (10.48 [10.07-10.88] to 4.32 [4.12-4.51], AAPC -4.6, p< 0.001). All urban areas saw a decrease in ASMR. Large, central metros saw the greatest percentage decline (7.1 [6.92-7.29] in 1999 to 2.7 [2.6-2.79] in 2020, AAPC -4.6, p< 0.001). Micropolitan areas saw the greatest absolute decline (8.77 [8.43-9.12] in 1999 to 3.88 [3.67-4.09] in 2020, AAPC -4.2, p< 0.001). Rural areas had higher mortality.

Conclusions: Overall, this study contributes valuable insights into the trends of mortality associated with complications of medical and surgical care, which are crucial for policymakers, healthcare professionals, and institutions to continue their efforts in optimizing patient safety and enhancing the quality of healthcare services. Further research and targeted interventions are necessary to sustain and further improve these positive trends and ensure equitable access to high-quality care for all populations across the US.