P5912 - Exploring the Etiological Spectrum of Liver Cirrhosis Mortality: A Nationwide Analysis Using CDC WONDER (1999-2023)

Usama Sakhawat, MD¹, Ahmed Shehadah, MD², Atif Nawaz Malik, MBBS³, Hamza Hameed, ⁴, Anfal Hamza, MBBS³, Manahil Shafique, ⁴, Misha Khalid, ⁵, Eesha Asghar Ali, MBBS⁶, Maryam Sial, MBBS⁷, Mariam Anwar, MBBS⁸, Muhammad Tasawar. Latif, MD⁹, Ahsan A. Nawaz, ¹⁰, Faseeh Haider, MD¹¹, Faizan Ahmad, MD¹², Allah Dad, MD¹³, Kinza Bakht, MBBS¹⁴, Tehmasp Rehman Mirza, MBBS¹⁵, Khandokar Talib, MD¹⁶, Amanke Oranu, MD²
1United Health Services, Wilson Medical Center, Johnson City, NY; 2United Health Services, Wilson Medical Center, Binghamton, NY; 3Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan, Rahim Yar Khan, Punjab, Pakistan; 4Sheikh Zayed Medical College, Rahim Yar Khan, Rahim Yar Khan, Punjab, Pakistan; 5Karachi medical and dental college, Karachi, Sindh, Pakistan; 6Liaquat University of Medical and Health Science, Karachi, Sindh, Pakistan; 7Sheikh zayed medical college, Lahore, Punjab, Pakistan; 8Baqai Medical University, Karachi, Karachi, Sindh, Pakistan; 9Yale New Haven Hospital, Middlebury, CT; 10Holy Family Hospital, Rawalpindi, Bhakkar, Punjab, Pakistan; 11Allama Iqbal Medical college, Lahore, Punjab, Pakistan; 12Duke University, Durham, NC; 13Shiekh Zayed Medical College Rahim Yar Khan, Pakistan, Kot Addu, Punjab, Pakistan; 14Sheikh Zayed Medical College Rahim Yar Khan, Muzaffargarh, Punjab, Pakistan; 15MBBS, Lahore, Punjab, Pakistan; 16United Health Services, Johnson City, NY

Introduction: Liver cirrhosis is the 11th leading cause of death globally, driven by multiple etiologies i.e,. viral hepatitis, alcohol, obesity, diabetes, and hepatic neoplasms. Nationwide cirrhosis-related mortality due to these etiologies remained underexplored. This study examines etiological cirrhosis-related mortality trends (1999–2023) in the U.S. population to identify high-risk populations and guide targeted interventions.

Methods: Mortality data among adults aged ≥ 55 spanning 1999-2023 were obtained from the CDC-WONDER database, focusing on deaths due to cirrhosis (ICD 10: K74) with all possible etiologies i.e. viral hepatitis (B15-19), alcoholic liver disease (K70), malignant hepatic and intrahepatic bile duct neoplasms (C22) and Other diseases of liver (K76). Age Adjusted Mortality rates (AAMRs) per 100,000 people were calculated and stratified according to different demographic and geographical variables. The Annual Percentage Change (APC) was calculated using Joinpoint regression with 95 % Confidence Interval (CI) and p< 0.05 taken as significant.

Results: A total of 38,028 deaths were attributed to Liver Cirrhosis from 1999 to 2023 having an average AAMR of 1.91 with a significant incline from 2018 to 2023, APC: 3.35 (95% CI: 2.09-6.25, p< 0.0001) Mortality among Females increased significantly from 2007-2023 with APC of 3.19 (95% CI: 2.67-3.92; p< 0.0001). Non Hispanics (2006-2023) exhibited a significantly increasing trend with APC: 2.14 (95%CI: 1.60-2.94, p< 0.0001). Among races, during 2019-2023 highest APC in mortality trends was exhibited by American Indians (APC: 8.72, 95%CI: 1.45-26.48, p=0.01). Mortality trends in Medium Metro (2006-2020), Small Metro (2002-2020) and Noncore (2007-2020) were highest with APC: 2.84 (95%CI: 2.06-4.12, p< 0.0001), 2.50 (95%CI: 1.66-5.12, p= 0.01) and 4.16 (95%CI: 3.07-6.40, p< 0.0001), respectively. Among Census regions, CENS:R2 (Midwest) and CENS:R4 (West) showed consistently increasing mortality trends from 2005 to 2023 with APC of 2.44 (95%CI: 1.70 to 3.82, p< 0.0001) and 2.07 (95%CI: 1.57 to 2.86, p< 0.0001), respectively.

Discussion: Liver cirrhosis mortality in the United States exhibited an initial decline during the first decade followed by a concerning increase especially in females, Non Hispanics, American Indians, and regions like the Midwest and West. These findings highlight the need for targeted interventions addressing specific etiologies leading to cirrhosis.


Figure: Central Illustration- Gender / Race / Regional and Ethnic Stratification.

Disclosures:
Usama Sakhawat indicated no relevant financial relationships.
Ahmed Shehadah indicated no relevant financial relationships.
Atif Nawaz Malik indicated no relevant financial relationships.
Hamza Hameed indicated no relevant financial relationships.
Anfal Hamza indicated no relevant financial relationships.
Manahil Shafique indicated no relevant financial relationships.
Misha Khalid indicated no relevant financial relationships.
Eesha Asghar Ali indicated no relevant financial relationships.
Maryam Sial indicated no relevant financial relationships.
Mariam Anwar indicated no relevant financial relationships.
Muhammad Latif indicated no relevant financial relationships.
Ahsan Nawaz indicated no relevant financial relationships.
Faseeh Haider indicated no relevant financial relationships.
Faizan Ahmad indicated no relevant financial relationships.
Allah Dad indicated no relevant financial relationships.
Kinza Bakht indicated no relevant financial relationships.
Tehmasp Rehman Mirza indicated no relevant financial relationships.
Khandokar Talib indicated no relevant financial relationships.
Amanke Oranu indicated no relevant financial relationships.

Usama Sakhawat, MD¹, Ahmed Shehadah, MD², Atif Nawaz Malik, MBBS³, Hamza Hameed, ⁴, Anfal Hamza, MBBS³, Manahil Shafique, ⁴, Misha Khalid, ⁵, Eesha Asghar Ali, MBBS⁶, Maryam Sial, MBBS⁷, Mariam Anwar, MBBS⁸, Muhammad Tasawar. Latif, MD⁹, Ahsan A. Nawaz, ¹⁰, Faseeh Haider, MD¹¹, Faizan Ahmad, MD¹², Allah Dad, MD¹³, Kinza Bakht, MBBS¹⁴, Tehmasp Rehman Mirza, MBBS¹⁵, Khandokar Talib, MD¹⁶, Amanke Oranu, MD². P5912 - Exploring the Etiological Spectrum of Liver Cirrhosis Mortality: A Nationwide Analysis Using CDC WONDER (1999-2023), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.