Penn State Health Milton S. Hershey Medical Center Hershey, PA
Muhammad Shahzil, MD1, Luqman Munir, 2, Zainab Alvi, MBBS2, Ali Akram Qureshi, 2, Minahil Fatima, 2, Muhammad Saad Faisal, MD3, Rabia Mukhtar, MD4, Ammad Javaid Chaudhry, MD3 1Penn State Health Milton S. Hershey Medical Center, Hershey, PA; 2King Edward Medical University, Lahore, Punjab, Pakistan; 3Henry Ford Health, Detroit, MI; 4Weiss Memorial Hospital, Chicago, IL
Introduction:
Chronic liver disease (CLD) and cirrhosis cause 2 million deaths annually. U.S. mortality rates increased during the COVID-19 pandemic, reaching 16.4 per 100,000 in 2022. The pandemic heightened risks for CLD patients, disrupted healthcare, and increased mortality, especially among younger individuals and those with alcoholic liver disease. This study examines U.S. CLD and cirrhosis mortality trends from 1999 to 2020, identifying demographic and regional patterns using age-adjusted mortality rates (AAMR) to inform targeted interventions.
Methods:
Data from the CDC Wonder database were analyzed for chronic liver failure-related deaths (ICD-10 code K72.1) from 1999 to 2020. Age-adjusted mortality rates per 1,000,000 of the U.S. Standard 2000 population were calculated. Trends were examined using Joinpoint Regression, stratified by gender, race, urbanization, and U.S. census regions. Age groups included pediatric, young adults, middle adults, and older adults. The Monte Carlo Permutation Procedure analyzed trends, with significance set at p< 0.05.
Results:
The investigation cataloged 13,547 chronic liver failure (CLF)-related deaths over the study period. Mortality rates rose from 1999 to 2002 (APC: 9.12), declined from 2002 to 2010 (APC: -3.46), and increased significantly from 2010 to 2020 (APC: 11.05). Higher mortality was observed among 65-74-year-olds (AAMR: 5.37), males (AAMR: 2.32), and White Americans (AAMR: 1.86). Males saw trends including an initial rise from 1999 to 2003 (APC: 11.18), a decline from 2003 to 2006 (APC: -11.42), a slight rise from 2006 to 2012 (APC: 1.36), and a significant increase from 2012 to 2020 (APC: 11.63). Females showed stability from 1999 to 2010 (APC: -1.24), followed by a rise from 2010 to 2020 (APC: 11.47). The Northeast saw a rise from 2013 to 2020 (APC: 14.07), while the South increased from 2011 to 2020 (APC: 12.77). Urbanization trends showed lower mortality in metropolitan areas. Large central metros declined from 1999 to 2012 (APC: -1.42) and rose from 2012 to 2020 (APC: 11.61).
Discussion:
The study highlights the significant burden of chronic liver disease (CLD) and cirrhosis on U.S. mortality. Rising mortality rates among older adults, males, and White Americans emphasize the need for targeted public health interventions. Regional and racial disparities, particularly among Black Americans, call for tailored healthcare strategies. Addressing these trends is crucial for reducing CLF-related mortality and ensuring equitable healthcare access.
Figure: Trends and Disparities in Chronic Liver Failure (CLF)-Related Deaths in the United States: A 1999-2020 Analysis
Disclosures:
Muhammad Shahzil indicated no relevant financial relationships.
Luqman Munir indicated no relevant financial relationships.
Zainab Alvi indicated no relevant financial relationships.
Ali Akram Qureshi indicated no relevant financial relationships.
Minahil Fatima indicated no relevant financial relationships.
Muhammad Saad Faisal indicated no relevant financial relationships.
Rabia Mukhtar indicated no relevant financial relationships.
Ammad Javaid Chaudhry indicated no relevant financial relationships.
Muhammad Shahzil, MD1, Luqman Munir, 2, Zainab Alvi, MBBS2, Ali Akram Qureshi, 2, Minahil Fatima, 2, Muhammad Saad Faisal, MD3, Rabia Mukhtar, MD4, Ammad Javaid Chaudhry, MD3. P2971 - Trends and Disparities in Chronic Liver Failure (CLF)-Related Deaths in the United States: A 1999-2020 Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
