P2683 - Demographic Distribution and Disparities in Mortality of Ulcerative Colitis and Crohn's Disease: A 21-Year Longitudinal Analysis Using the CDC WONDER Database (1999-2020)
Fatemeh Homayounieh, MD1, Swetha Mynedi, MD2, Aryan Zahergivar, MD3, Abay A. Gobezie, MD4, Alem Mehari, MD2, Angesom Kibreab, MD2 1Howard University Hospital, Bethesda, MD; 2Howard University Hospital, Washington, DC; 3National Institutes of Health, Bethesda, MD; 4Howard University Hospital, Riverdale, MD
Introduction: To compare the demographic distribution and leading causes of death in patients with Ulcerative Colitis (UC) and Crohn's Disease (CD) identified as their underlying cause of death.
Methods: To investigate the underlying cause of death (UCOD) and multiple causes of death (MUCOD) for both UC and CD across the US at a national population level, we analyzed data from 1999-2020, obtained from the CDC's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. We included individuals aged 15 years and older and extracted demographic data (age, gender, race and ethnicity, region, and urbanization) for both CD and UC (ICD-10 codes: K50 and K51). Crude mortality rates were calculated per 1,000,000. Descriptive statistics, Student’s t-tests, regression analysis, and ANOVA were performed using Microsoft Excel 2019 (Microsoft Inc.) and SPSS (IBM SPSS Statistics Inc.).
Results: From 1999 to 2020 in the U.S., while annual deaths from CD (13,119) are significantly higher than UC (7,198) (p< 0.0001), both diseases caused significantly more deaths in females (CD 7,608; UC 3,942) than males (CD 5,511; UC 3,256) (p< 0.0001). Crude mortality rates for CD and UC differ significantly by race and ethnicity, highest in Whites (CD 2.75; UC 1.53), lowest in Asians (CD 0.22; UC 0.31). Analysis showed significant regional and urbanization differences in mortalities for CD and UC, with the Midwest highest for CD, South lowest for UC, and lower rates in urban areas (p< 0.0001). Age-stratified analysis shows no significant overall difference in mortalities for CD and UC (p=0.280). However, in ages 20-70, CD crude mortality rate (1.57) is significantly higher than UC (0.59) (p=0.037), especially in ages 30-50, where CD deaths are five times higher than UC. “Malignant Neoplasm” (ICD-10 code: C00-C97) is identified as the leading cause of death in both groups, while in the general population, “Diseases of heart” (ICD-10 codes: I00-I09, I11, I13, I20-I51) is the leading cause of death.
Discussion: This comprehensive analysis demonstrates significant disparities in mortality rates between CD and UC over two decades. CD exhibits higher mortality rates, particularly in individuals aged 20-70. These findings underscore the necessity for targeted screening, preventive measures, and tailored management strategies to address the distinct health risks and reduce mortality in UC and CD patients.
Figure: Column and line chart demonstrating crude mortality rates per 1,000,000 for UCOD identified as UC or CD within different racial/Ethnic groups (A-B) and 5-year age groups (C-D) in the U.S. Population Aged Over 15 Years (1999-2020) [UCOD: Underlying cause of death; UC: Ulcerative colitis; CD: Crohn’s disease]
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Fatemeh Homayounieh indicated no relevant financial relationships.
Swetha Mynedi indicated no relevant financial relationships.
Aryan Zahergivar indicated no relevant financial relationships.
Abay Gobezie indicated no relevant financial relationships.
Alem Mehari indicated no relevant financial relationships.
Angesom Kibreab indicated no relevant financial relationships.
Fatemeh Homayounieh, MD1, Swetha Mynedi, MD2, Aryan Zahergivar, MD3, Abay A. Gobezie, MD4, Alem Mehari, MD2, Angesom Kibreab, MD2. P2683 - Demographic Distribution and Disparities in Mortality of Ulcerative Colitis and Crohn's Disease: A 21-Year Longitudinal Analysis Using the CDC WONDER Database (1999-2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
