P1543 - Trends and Disparities in Mortality Due to Alcoholic Cirrhosis in the United States: A Decadal Analysis Using CDC WONDER (1999-2023)

Muhammad Waqar Elahi, MD¹, Aamer Ahmad, MD², Shehroz Yar Khan, MD², Ahmed Jadoon, MBBS², Waqas Ali, MD¹, Muhammad Sohail, MD², Eric Huang, MD¹, Shahryar Khan, MD³, Arooj Fatima, MD⁴, Ahmad Khan, ², Hira Hameed, MD⁵, Ibrahim Sayyid, MD¹
1West Virginia University School of Medicine, Morgantown, WV; 2Khyber Medical University, Peshawar, North-West Frontier, Pakistan; 3University of Kansas Medical Center, Kansas City, KS; 4Khyber Medical University, Morgantown, WV; 5Jinnah Hospital Lahore, Lahore, Punjab, Pakistan

Introduction: Alcoholic cirrhosis is emerging as a growing cause of liver-related deaths in the U.S., coinciding with a decline in hepatitis-related mortality. Recent trends show sharp increase, particularly among younger adults, females, and racial minorities. This study analyzes national data from 1999–2023 to examine evolving patterns and disparities in alcoholic cirrhosis mortality.

Methods: Death certificates from CDC WONDER database were examined from 1999 to 2023 for multiple causes of death UCD-ICD 10 Codes (K70.3). Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by gender, race/ethnicity, ten-year age groups and census region. Join-Point analysis was performed to estimate annual percent change (APC).

Results: From 1999 to 2023, 329,223 deaths occurred in adults >25 years due to alcoholic cirrhosis. Overall AAMR rose from 4.09 in 1999 to 4.92 in 2011 (APC: 1.45%,95% CI: –0.14 to 2.76), then sharply to 10.6 in 2021 (APC: 7.02%, 95% CI: 3.35 to 10.78, p=0.03), before declining to 8.93 in 2023 (APC: –10.9%, 95% CI: –5.72 to 5.71). By gender, male AAMR increased from 6.69 to 12.43, and female AAMR from 1.9 to 5.63, both peaking in 2021 (males: 14.11; females: 6.25). A sharp rise occurred from 2018–2021 (males APC: 11.06%; females APC: 14.43%, p < 0.000001), followed by a decline through 2023 (males APC: –5.51%; females APC: –4.76%).Age-specific rates rose in both groups (25–64: 3.71 to 8.41; 65+: 5.64 to 11.00), with a steeper rise in the younger group, both peaking in 2021. By race, NH American Indians had the highest 2023 AAMR (39.87), followed by Hispanics (10.84), NH Whites (9.54), and NH Blacks (5.06). NH American Indians showed a dramatic pandemic peak in 2021 (64.69). Regionally, the West had the highest 2023 AAMR (12.93), followed by the South (8.32), Midwest (8.24), and Northeast (5.64).

Discussion: Alcoholic cirrhosis mortality has more than doubled in two decades, with surges during COVID-19, especially in younger adults, females, and NH American Indians. The recent decline post-2021 offers hope but highlights a critical window for intervention. These findings emphasize the urgent need for targeted public health strategies, improved addiction treatment access, and culturally tailored prevention programs. Our study quantifies this shifting landscape and calls for policy reform to reduce preventable alcohol related deaths.

Disclosures:
Muhammad Waqar Elahi indicated no relevant financial relationships.
Aamer Ahmad indicated no relevant financial relationships.
Shehroz Yar Khan indicated no relevant financial relationships.
Ahmed Jadoon indicated no relevant financial relationships.
Waqas Ali indicated no relevant financial relationships.
Muhammad Sohail indicated no relevant financial relationships.
Eric Huang indicated no relevant financial relationships.
Shahryar Khan indicated no relevant financial relationships.
Arooj Fatima indicated no relevant financial relationships.
Ahmad Khan indicated no relevant financial relationships.
Hira Hameed indicated no relevant financial relationships.
Ibrahim Sayyid indicated no relevant financial relationships.

Muhammad Waqar Elahi, MD¹, Aamer Ahmad, MD², Shehroz Yar Khan, MD², Ahmed Jadoon, MBBS², Waqas Ali, MD¹, Muhammad Sohail, MD², Eric Huang, MD¹, Shahryar Khan, MD³, Arooj Fatima, MD⁴, Ahmad Khan, ², Hira Hameed, MD⁵, Ibrahim Sayyid, MD¹. P1543 - Trends and Disparities in Mortality Due to Alcoholic Cirrhosis in the United States: A Decadal Analysis Using CDC WONDER (1999-2023), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.