University of Mississippi Medical Center Jackson, MS
Saleha Aziz, MD1, Anum Akhlaq, MD1, Aun Muhammad, MBBS1, Jan Petrasek, MD, PhD2 1University of Mississippi Medical Center, Jackson, MS; 2Texas Liver Institute, San Antonio, TX
Introduction: Autoimmune hepatitis (AIH) is associated with a good prognosis when treated effectively. Yet, untreated cases can have a mortality rate approaching 40%. This study examines national mortality trends from 2003 to 2020, focusing on demographic and regional disparities.
Methods: Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research was used to access data from 2003 to 2020. Adults aged 25 years and older diagnosed with AIH (ICD-10 code K75.4) were included. Age-adjusted mortality rates (AAMR) were calculated, and annual average percentage change (AAPC) was assessed using joinpoint regression. Mortality was stratified by age, sex, race (Caucasian, Hispanic, African American), census region (South, West, Midwest, Northeast), and state. The location of death (home, inpatient facility, hospice, nursing home, outpatient) was also examined.
Results: A total of 11,825 AIH deaths occurred during the study period. The overall AAMR was 0.25 per 100,000 adults and showed a slight but significant increase over time (AAPC +1.74, 95% CI 0.60 to 3.03). Females (AAMR 0.38) had higher rates than males (0.11). AAMR was highest in age group ≥65 years (0.97), followed by 45 to 64 years (0.24), and 25 to 44 years (0.10). While most deaths were among Caucasian adults (8,287), Hispanic adults had the highest AAMR (0.42). Notably, the Western region, particularly Wyoming, experienced the highest rates (AAMR 0.38). Most deaths occurred in inpatient facilities (6,212), followed by the decedent's home (2,832).
Discussion: This study reveals a modest but increasing mortality burden due to AIH in the US. Significant disparities exist, with higher rates among females, Hispanics, the elderly, and individuals residing in the West. Our findings emphasize the need for increased awareness and improved access to care, especially for vulnerable populations, to mitigate these disparities and improve outcomes for AIH patients.
Figure: Age adjusted mortality rates in adults with autoimmune hepatitis in the United States
Disclosures:
Saleha Aziz indicated no relevant financial relationships.
Anum Akhlaq indicated no relevant financial relationships.
Aun Muhammad indicated no relevant financial relationships.
Jan Petrasek indicated no relevant financial relationships.
Saleha Aziz, MD1, Anum Akhlaq, MD1, Aun Muhammad, MBBS1, Jan Petrasek, MD, PhD2. P4628 - The Changing Landscape of Autoimmune Hepatitis Mortality in the United States, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
