P2459 - Analyzing Trends and Disparities in Adults GI Bleed Mortality in the US (1999-2020) Using CDC WONDER Data

Faraz Arshad, MBBS¹, Khawaja Abdul Rehman, MBBS², Rohab Sohail, MBBS³, Humza Saeed, MBBS⁴, Sadaf Iftikhar MD, MD⁵, M Danial Ali Shah, MD⁶, Javeria Javeid, MBBS⁷, Sabin Zafar, MBBS⁸, Syed Adeel Hassan, MBBS^9
1Shaikh Zayed Hospital, Gujrat, Punjab, Pakistan; ²CMH Lahore Medical College, Lahore, Punjab, Pakistan; ³Quaid-e-Azam Medical College, Bahawalpur, Punjab, Pakistan; ⁴Rawalpindi Medical University, Islamabad, Islamabad, Pakistan; ⁵Akhtar Saeed Medical and Dental College, Al Dilam, Ar Riyad, Saudi Arabia; ⁶King Edward Medical University, Lahore, Punjab, Pakistan; ⁷Allama Iqbal Medical College, Lahore, Punjab, Pakistan; ⁸Jinnah Sindh Medical University, Karachi, Sindh, Pakistan; ⁹University of Kentucky, Lexington, KY

Introduction: Gastrointestinal (GI) bleeding is a life-threatening condition with a variable incidence and mortality rate. While GI bleeding has been extensively studied, there needs to be more emphasis on examining demographic factors associated with GI bleed mortality within the United States (US). Here, we aim to identify temporal trends in upper and lower GI bleed mortality among adults in the US stratified by age, sex, race, region, state, and place of death

Methods: Using data from the CDC WONDER database, we determined the crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals from 1999-2020. We used Joinpoint regression to examine the changes in AAMR through annual percent change (APC) and the average annual percent change (AAPC).

Results: A total of 80,3987 deaths were reported due to GI bleeding from 1999-2020 in the US, with an overall decreasing trend (AAPC = -0.99). AAMR steeply declined from 1999 to 2009 (APC: -3.73, 95% CI: -4.36 to -3.30), followed by a slight non-significant increase from 2009 to 2018 (APC: 0.39, 95% CI: -1.07 to 1.14) in AAMR. However, there was a sharp increase in AAMR from 2018 to 2020 (APC: 7.06, 95% CI: 2.37 to 9.46). Although males (21.4) had a significantly higher AAMR than females (13.2), there was nearly equal decrease in mortality in both (Females, AAPC: -0.91; Males, AAPC: -1.00). AAMR was highest among Non-Hispanic (NH) American Indians or Alaska Natives (26.6) and the lowest among NH Asian or Pacific Islanders (11.3). A significant geographical difference was observed among US census regions (Midwest: 17.1, Northeast: 17, West: 16.4, South: 16.8). States with highest AAMR were Columbia (24.4) and West Virginia (23). States with the lowest AAMR were Florida (12.9) and Arizona (13.4). Non-metropolitan areas (19.5) had a higher AAMR than metropolitan areas (16.3). Most deaths occurred in the medical facility (68.7%) and least in nursing homes (3.3%).

Discussion: Our nationwide analysis showed an overall decreasing mortality trend due to GI bleeding among adults in the US. This decline may be attributed to advancements in diagnostic and therapeutic endoscopic measures. However, the drastic increase in the overall mortality rate from 2018 to 2020 is concerning in males, NH American Indians or Alaska Natives, and Midwest region. These findings provide valuable information for public health initiatives to focus on policy adjustment for these high-risk individuals and aim to improve equitable access to preventative and therapeutic interventions



Disclosures:


Faraz Arshad, MBBS¹, Khawaja Abdul Rehman, MBBS², Rohab Sohail, MBBS³, Humza Saeed, MBBS⁴, Sadaf Iftikhar MD, MD⁵, M Danial Ali Shah, MD⁶, Javeria Javeid, MBBS⁷, Sabin Zafar, MBBS⁸, Syed Adeel Hassan, MBBS⁹. P2459 - Analyzing Trends and Disparities in Adults GI Bleed Mortality in the US (1999-2020) Using CDC WONDER Data, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.