To examine disparities in sepsis-related mortality among Parkinson patients by sex, race/ethnicity, and geographic region.

Sepsis remains a leading cause of morbidity and mortality in the United States, disproportionately affecting patients with neurological disorders. Parkinson disease (PD) may increase susceptibility to infections and adverse systemic outcomes due to risk factors such as dysphagia and immobility leading to aspiration pneumonia and pressure ulcers respectively, which can lead to sepsis. National trends in sepsis-related mortality among individuals with PD have not been well characterized.

Age-adjusted Mortality Rates (AAMRs) per 100,000 in adults (65+) were obtained from the CDC WONDER using ICD-10 Codes for Parkinson Disease (G20) and Sepsis (A41). Joinpoint regression estimated Annual percent Change and average APC, with significance at p<0.5.

From 1999 to 2023, 43,874 sepsis related deaths occurred among Parkinson patients who were adults (65+). The overall AAMR fell slightly from 4.8 in 1999 to 4.4 in 2023 (AAPC: -0.02; 95% CI:  -0.56-0.51, p = 0.920978). Males accounted for 63.2 % of deaths. Males had higher AAMR than females (6.5 % vs 2.5 %), with females exhibiting a steep fall (AAPC: -0.6%; 95% CI: -1.3 to 0.09, p=0.088860). NH Whites had the highest AAMR (4.2) while NH Asians had the steepest rise in mortality (AAPC: 0.8; 95% CI: -0.03 to 1.5, p=0.060434). The Northeast had the highest AAMR (4.4), with the West exhibiting a rising trend (AAPC:0.9, p=0.000059). States with the highest mortality include Maryland, Kentucky and Oklahoma. Urban rural differences were modest ,with the highest mortality observed in Large Central Metro regions.

Sepsis related deaths in Parkinson patients have increased despite improved access and advancements in diagnosis, pharmacotherapy and earlier interventions. Disparities are notable in males, NH Whites, Northeast, states such as Maryland and urban regions. Targeted interventions are needed.