P1229 - Trends in Mortality Due to Esophageal Varices in Liver Disease Patients Aged 25 and Older in the United States: Insights from the CDC WONDER Database

Muhammad Naveed, MBBS¹, Mohammad Faisal Iftikhar, MD², Rabia Iqbal, MBBS¹, Ahila Ali, MBBS¹, Bazil Azeem, MBBS³, Muhammad Omer Rehan, MBBS¹, Faizan Ahmed, MBBS⁴, Nouman Shafique, MD⁵, Usama Sakhawat, MD^6
1Dow Medical College, Karachi, Sindh, Pakistan; ²Wright Center for Graduate Medical Education, Scranton, PA; ³Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Sindh, Pakistan; ⁴Ameer Ud Din Medical College/ Lahore General Hospital, Lahore, Punjab, Pakistan; ⁵AdventHealth Medical Group, AdventHealth, Orlando, FL; ⁶United Health Services, Wilson Medical Center, Binghamton, NY

Introduction: Esophageal varices in liver disease patients is a dreaded complication among patients with chronic liver disease in the United States. Our study examines trends and demographic disparities in mortality rates due to esophageal varices in liver disease patients aged 25 and older from 1999 to 2020

Methods: A retrospective analysis was conducted using death data from the CDC WONDER database spanning 1999-2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions.

Results: Between 1999 and 2020, esophageal varices in liver disease accounted for 55,865 deaths among adults aged 25+ in the U.S. The overall AAMR for esophageal varices in liver disease-related deaths increased from 1.4 in 1999 to 1.6 in 2020, with an AAPC of -0.11 (95% CI: -0.57 to 0.38, p = 0.627). A significant decline occurred from 1999 to 2007 (APC: -6.14; 95% CI: -8.56 to -4.34, p < 0.000001), followed by a notable increase from 2007 to 2020 (APC: 3.79; 95% CI: 2.92 to 5.05, p = 0.048). Men exhibited higher AAMRs compared to women (men: 1.8; women: 0.6). The AAMR for men decreased while that for women increased from 1999 to 2020 [Men: AAPC: -0.47, (CI: -0.83 to -0.09) (p = 0.017); Women: AAPC: 0.48, (CI: -0.18 to 1.25) (p = 0.144)]. American/Alaska Natives had the highest AAMRs (3.7), followed by Hispanics (2.1), Blacks (1.1), Whites (1.1), and Asians (0.6). AAMRs decreased notably for Blacks, Asians, and Hispanics, increased for American Indians, and remained stable for Whites. Geographically, AAMRs ranged from 0.8 in Georgia to 2.4 in New Mexico. The highest mortality was in the Western region (AAMR: 1.6). Nonmetropolitan areas had higher AAMRs than metropolitan areas (1.3 vs. 1.1), with a significant increase in nonmetropolitan areas (AAPC: 1.94, p < 0.000001) and a decrease in metropolitan areas (AAPC: -0.15, p = 0.356).

Discussion: Our analysis highlights significant demographic and geographic disparities in mortality rates due to oesophageal varices in liver disease patients among adults aged 25 and older in the U.S. Despite a significant early decline, the recent increase in mortality rates underscores the need for targeted prevention strategies and interventions to address these disparities and improve health outcomes.



Disclosures:


Muhammad Naveed, MBBS¹, Mohammad Faisal Iftikhar, MD², Rabia Iqbal, MBBS¹, Ahila Ali, MBBS¹, Bazil Azeem, MBBS³, Muhammad Omer Rehan, MBBS¹, Faizan Ahmed, MBBS⁴, Nouman Shafique, MD⁵, Usama Sakhawat, MD⁶. P1229 - Trends in Mortality Due to Esophageal Varices in Liver Disease Patients Aged 25 and Older in the United States: Insights from the CDC WONDER Database, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.