P5800 - Unraveling the Trends and Disparities in Mortality of Liver Cirrhosis and Sepsis Across the United States: A 21-Year Retrospective Analysis

Kinza Asghar, MBBS¹, Azka Aisha, MBBS¹, Maryam Asghar, MBBS¹, Aqsa Komel, MBBS¹, Anum Khakwani, MD², Haseeb Ali, MBBS¹, Esha Umair, MBBS¹, Muhammad Hassan, MBBS¹, Muneeb Khawar, MBBS³, Moiz Ul Haq Hashmi, MBBS¹, Ayesha Khan, MBBS¹, Huzaifa Noor, MBBS¹, Muhammad Siddiqui, MBBS¹, Roohi Bano, MBBS¹, Laiba Yumn, MBBS¹
1Nishtar Medical University, Multan, Punjab, Pakistan; 2Charleston Area Medical Center, Charleston, WV; 3King Edward Medical University, Lahore, Punjab, Pakistan

Introduction: Sepsis in Liver cirrhosis (LC) patients is a dreaded complication and often overlooked. Our study examines the trends and mortality rates due to sepsis in liver cirrhosis patients across the US adult population from 1999-2020, to serve as a guide for further management.

Methods: Data was used from the CDC WONDER database, including adults aged 25 and older. Mortality data were identified using ICD-10 codes K74.3-K74.6 and A41.9. AAMRs per 100,000 population. This was stratified by gender, race, census region, urban-rural classification, and state. JOINPOINT analysis done to estimate average annual percent changes (AAPCs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05.

Results: Between 1999 and 2020, liver cirrhosis and sepsis accounted for 83,551 deaths among adults aged ≥25 in the US. The overall AAMR for sepsis in liver cirrhosis-related deaths increased from 1.3282 in 1999 to 2.4387 in 2020, with an AAPC of 2.7641 (95% CI: 1.75 to 3.79, p<0.000001). Men exhibited higher AAMRs compared to women (men: 2.12; women: 1.39). AAMRs for men and women increased steadily from 1999 to 2020 [AAPC: 2.05* (95%CI: 0.83 to 3.28, p=0.00091)], [AAPC: 3.76* (95%CI: 3.19 to 4.32, p</span><0.000001)], respectively.

American Indian/Alaska Natives had the highest AAMRs (3.28), followed by Hispanics (3.02), Black population (1.83), White population (1.72), and Asians (1.14). AAPC values for AAMRs increased significantly for American Indians (3.07*) and White population (3.04*) while increased non-significantly for Hispanics(0.86), Asians(0.78) and Black population(0.66).

Geographically,Metropolitan areas had higher AAMRs (1.729) than Non-metropolitan areas (1.702).AAPC values of AAMR is highest for NonCore(Nonmetro) which is 5.82* , followed by Micropolitan(4.53*), Small Metro(3.84), Medium Metro(3.67*), Large Fringe Metro(1.92*), and Large Central Metro(0.79).

At the state level, the highest increases were seen in Maryland (APC: 22.98* from 2016–2020), Michigan (APC: 14.18* from 2017–2020), and *Oklahoma (APC: 10.51* from 2010–2020). States like Florida and New York showed earlier declines or stable trends.

Discussion: This analysis reveals key trends in liver cirrhosis-related sepsis mortality, showing disparities across gender, race, region, and urbanization. Males and American Indian/Alaska Natives had the highest mortality rates, highlighting health inequalities and the need for further targeted research and interventions.



Figure: Demographic Characteristics of Liver Cirrhosis and Sepsis


Figure: LC and sepsis illustration

Disclosures:
Kinza Asghar indicated no relevant financial relationships.
Azka Aisha indicated no relevant financial relationships.
Maryam Asghar indicated no relevant financial relationships.
Aqsa Komel indicated no relevant financial relationships.
Anum Khakwani indicated no relevant financial relationships.
Haseeb Ali indicated no relevant financial relationships.
Esha Umair indicated no relevant financial relationships.
Muhammad Hassan indicated no relevant financial relationships.
Muneeb Khawar indicated no relevant financial relationships.
Moiz Ul Haq Hashmi indicated no relevant financial relationships.
Ayesha Khan indicated no relevant financial relationships.
Huzaifa Noor indicated no relevant financial relationships.
Muhammad Siddiqui indicated no relevant financial relationships.
Roohi Bano indicated no relevant financial relationships.
Laiba Yumn indicated no relevant financial relationships.

Kinza Asghar, MBBS¹, Azka Aisha, MBBS¹, Maryam Asghar, MBBS¹, Aqsa Komel, MBBS¹, Anum Khakwani, MD², Haseeb Ali, MBBS¹, Esha Umair, MBBS¹, Muhammad Hassan, MBBS¹, Muneeb Khawar, MBBS³, Moiz Ul Haq Hashmi, MBBS¹, Ayesha Khan, MBBS¹, Huzaifa Noor, MBBS¹, Muhammad Siddiqui, MBBS¹, Roohi Bano, MBBS¹, Laiba Yumn, MBBS¹. P5800 - Unraveling the Trends and Disparities in Mortality of Liver Cirrhosis and Sepsis Across the United States: A 21-Year Retrospective Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.