P5922 - Evaluating the Temporal Trends in Mortality due to Liver Cirrhosis versus Cirrhosis With Ascites: A Retrospective Analysis From CDC-WONDER and ARIMA Model

Arbaz Hassan, MBBS¹, Atif Nawaz Malik, MBBS¹, Talha Sajjad, MBBS, MD¹, Iqra Baig, ², Muhammad Saim, MBBS³, Anfal Hamza, MBBS¹, Minahil Ghaffar, ⁴, Muhammad Areeb Ul Haq, ⁵, Ahmad Sarim Aziz, MBBS⁶, Shahid Abbas, ⁴, Usman Afzal, MD⁷, Muhammad Arham, ⁸, Bisher Sawaf, MD⁹
1Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan, Rahim Yar Khan, Punjab, Pakistan; 2Shiekh Zayed Medical College, Rahim Yar Khan, Sadiqabad, Punjab, Pakistan; 3Seikh Zayed Medical College Rahim Yar Khan, Rahim Yar Khan, Punjab, Pakistan; 4Sheikh Zayed Medical College, Rahim Yar Khan, Rahim Yar Khan, Punjab, Pakistan; 5Allama Iqbal Medical College, Lahore, Punjab, Pakistan; 6Azra Naheed Medical College, Lahore, Pakistan, Lahore, Punjab, Pakistan; 7MedStar Health, Washington, D.C., DC; 8Sheikh Zayed Medical College, Pakistan, Rahim Yar Khan, Punjab, Pakistan; 9University of Toledo Medical Center, Toledo, OH

Introduction: Liver Cirrhosis is the leading cause of mortality in middle-aged Americans, with even worse outcomes when effected with Ascites. This study seeks to evaluate the comparative mortality trends in Liver Cirrhosis as a single cause of death vs Liver Cirrhosis with comorbid Ascites from 1999-2023.

Methods: A retrospective analysis was conducted using CDC Wonder database (1999 to 2023). Individuals aged ≥45 years with liver cirrhosis (ICD-10 K74) and Liver cirrhosis with underlying ascites (ICD-10 K74 + R18) were analyzed. Age-adjusted mortality rates (AAMRs) per 100,000 were stratified across year, gender, race/ethnicity, urbanization, region, and state. Annual percentage changes (APCs) were assessed using Bayesian information Criterion (BIC) approach in joinpoint regression (JPR) analysis, with p-value set at < 0.05. An autoregressive integrated moving average (ARIMA) model was applied to forecast mortality trends from 2024 to 2030 which was validated through Ljung-box test

Results: Liver cirrhosis accounted for 411,182 deaths with overall AAMR of 13.24 which is forecasted to reach14.5 (95% CI: 12.62-16.37; Ljung-box test P-value=0.177) till 2030. Death toll due to cirrhosis complicated with Ascites was 17,448 with AAMR of 0.56 (predicted as 1.25 till 2030). Males (1999-2009), non-Hispanics (1999-2008) and African Americans (1999-2008) exhibited significant deflection in mortality trends of Liver cirrhosis with APC of -1.21 (95% CI: -1.89 to -0.57; p=0.02), -1.20 (-2.11 to -0.58; p=0.00) and -2.42 (95% CI: -5.45 to -1.24; p=0.00), respectively. However, in Ascites group, sharp rise was observed in Hispanics (2008-23), Male (2010-23) and whites (2011-23) with APC of 3.57 (95% CI: 2.28-8.69; p=0.00), 4.92 (95% CI: 4.17-6.01; p=0.00) and 6.19 (95% CI: 4.75-8.59; p=0.00), respectively. CENS R3: south (mean AAMR= 16.29) and Texas (21.2) were the predominant regions in Liver Cirrhosis while CENS R3: south (mean AAMR= 0.64) and west Virginia (0.9) displayed highest AAMRs in Ascites complicated Liver Cirrhosis.

Discussion: Mortality fluctuated several times in both comparison groups for the whole study period, specifically substantial rise in Ascites complicated Liver Cirrhosis in recent years. These rising trends in males and whites provide pertinent insights about cirrhotic patients with ascites. Strengthened preventive measures and implications of subtle healthcare policies are needed to latch existing gaps.


Figure: Evaluating the temporal trends in mortality due to Liver Cirrhosis versus Cirrhosis with Ascites: A retrospective analysis from CDC-WONDER and ARIMA Model


Figure: Evaluating the temporal trends in mortality due to Liver Cirrhosis versus Cirrhosis with Ascites: A retrospective analysis from CDC-WONDER and ARIMA Model

Disclosures:
Arbaz Hassan indicated no relevant financial relationships.
Atif Nawaz Malik indicated no relevant financial relationships.
Talha Sajjad indicated no relevant financial relationships.
Iqra Baig indicated no relevant financial relationships.
Muhammad Saim indicated no relevant financial relationships.
Anfal Hamza indicated no relevant financial relationships.
Minahil Ghaffar indicated no relevant financial relationships.
Muhammad Areeb Ul Haq indicated no relevant financial relationships.
Ahmad Sarim Aziz indicated no relevant financial relationships.
Shahid Abbas indicated no relevant financial relationships.
Usman Afzal indicated no relevant financial relationships.
Muhammad Arham indicated no relevant financial relationships.
Bisher Sawaf indicated no relevant financial relationships.

Arbaz Hassan, MBBS¹, Atif Nawaz Malik, MBBS¹, Talha Sajjad, MBBS, MD¹, Iqra Baig, ², Muhammad Saim, MBBS³, Anfal Hamza, MBBS¹, Minahil Ghaffar, ⁴, Muhammad Areeb Ul Haq, ⁵, Ahmad Sarim Aziz, MBBS⁶, Shahid Abbas, ⁴, Usman Afzal, MD⁷, Muhammad Arham, ⁸, Bisher Sawaf, MD⁹. P5922 - Evaluating the Temporal Trends in Mortality due to Liver Cirrhosis versus Cirrhosis With Ascites: A Retrospective Analysis From CDC-WONDER and ARIMA Model, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.