Methods: We obtained mortality data from the National Center for Health Statistics (NCHS), which receives information from death certificates from all 50 states, including demographic information and cause of death (primary and contributing). The U.S. Multiple Cause of Death Files were searched from 2003 through 2013 for a listing of NF (ICD10 code M72.6) as either the primary or contributing cause of death. In order to study S. aureus-associated cases of fatal NF, we further selected cases with a diagnosis of S. aureus septicemia (ICD10 A41.0), as results from tissue cultures in NF are not included as an ICD10 diagnosis. We first examined the overall distribution of demographic factors of fatal cases of S. aureus-associated NF, then used a non-parametric extension of the Wilcoxon rank-sum test (nptrend, Stata v13) to examine temporal changes in mortality during the study period.
Results: We identified a total of 486 deaths caused by S. aureus-associated NF during between 2003 and 2013. Most patients were men (52.5%) and of white, non-Hispanic race/ethnicity (65%). The greatest number of deaths occurred among patients age 55-64 years old, and overall 71% of patients were age 55 or older. In time trend analysis, we observed a non-significant increase in the number of fatal S. aureus-associated NF cases each year (p=0.07), with a significant increase in the number of cases occurring in patients age 55 and older (p=0.04).
Conclusion: In the U.S. between 2003-2013, fatal cases of S. aureus-associated NF were predominantly observed in older individuals of white, non-Hispanic ethnicity. In future work we will examine co-morbid conditions of these patients, and utilize census data to generate age-adjusted mortality rates.
C. Vinnard, None
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