Acute Respiratory Distress Syndrome (ARDS) Mortality Trends in the United States of America (USA) From 1999-2022 and Future Predictions Using Machine Learning

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Abstract Rationale: Acute Respiratory Distress Syndrome (ARDS) is a critical condition with a historically high mortality rate in the United States. Since the COVID-19 pandemic, which has been associated with severe respiratory complications similar to ARDS, understanding ARDS-related mortality trends has gained renewed importance. Identifying disparities in ARDS mortality across demographics can inform targeted public health interventions to reduce mortality and address gaps in health care resources for vulnerable populations. Methods: We analyzed ARDS mortality data (International Classification of Diseases code J80) from 1999 to 2022 using the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 population were assessed by gender, race, and year. Trends were examined using joinpoint regression analysis to calculate the annual percent change (APC) in AAMR with 95% confidence intervals (CI). The ARIMA model was applied using Python software to forecast future mortality trends. Results: Between 1999 and 2022, a total of 44,866 deaths were attributed to ARDS. The AAMR for males was consistently higher than for females across the years, with notable fluctuations in the trends. State-wise, Alabama exhibited the highest AAMR (1.0; CI: 0.9-1.0), followed by Mississippi (0.9; CI: 0.8-1.0) and West Virginia (0.8; CI: 0.7-0.8). County-level analysis revealed Calhoun County, AL, with an AAMR of 2.2 (CI: 1.6-2.8), as having the highest mortality rate. Racial disparities in AAMR were observed, with Black or African American populations showing higher rates (0.7; CI: 0.6-0.7) compared to White populations (0.5; CI: 0.5-0.5) and Asian or Pacific Islander populations (0.4; CI: 0.3-0.4). The ARIMA model forecasted a gradual decline in AAMR over the next five years, with projections of 0.38 in 2023, 0.37 in 2024, 0.36 in 2025, 0.36 in 2026, and 0.35 in 2027. Conclusion: This analysis reveals persistent gender, racial, and regional disparities in ARDS-related mortality in the United States, underscoring the need for targeted policy interventions, especially in high-risk states and among vulnerable racial groups. Despite the prominence of ARDS as a complication in severe COVID-19 cases, our study found no significant spike in overall ARDS mortality during the pandemic. This unexpected trend warrants further research to enhance our understanding of the factors contributing to these disparities and the nuanced impact of COVID-19 on ARDS mortality.

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