P5221 - Trends and Disparities in Gastrointestinal Bleeding Mortality Among Older Adults in the US (1999–2020)

Ramish Hannat, MD¹, Ayesha Mubbashir, MD², Bisher Sawaf, MD³, Amin Abu Hejleh, MD⁴, Komail Khalid Meer, MD², Amine Rakab, MD⁵, Sneha Vijay, MD², Muhammad Hamza Shuja, MD⁶, Ahmad Shahid, MD⁷, Huda Ahmed, MD⁸
1Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; 2Dow University of Health Sciences, Karachi, Sindh, Pakistan; 3The University of Toledo, Toledo, OH; 4Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, Dubai, United Arab Emirates; 5Division of Medical Education, Weill Cornell Medicine, Doha, Ad Dawhah, Qatar; 6Dow Medical College, Toledo, Azad Kashmir, Pakistan; 7Dow Medical College, Kashmir, Azad Kashmir, Pakistan; 8Dow University of Health Sciences, Karachi, Azad Kashmir, Pakistan

Introduction: Gastrointestinal (GI) bleeding is a significant cause of hospitalizations and mortality among older adults. While prior studies have examined GI bleeding in general populations, limited research has focused specifically on mortality trends among U.S. adults aged 65 and older. This study aims to analyze GI bleeding–related mortality among older adults.

Methods: We analyzed the CDC WONDER database (1999–2020) for deaths attributed to GI bleeding (ICD-10 codes: K25.0, K25.2, K25.4, K25.6, K26.0, K26.2, K26.4, K26.6, K27.0, K27.2, K27.4, K27.6, K28.0, K28.2, K28.4, K28.6, K29.0, K62.5, K92.0, K92.1, K92.2) among adults aged ≥65 years. Mortality data were stratified by sex, race/ethnicity, urban-rural classification, geographic region, and U.S. state. Age-adjusted mortality rates (AAMRs) per 100,000 population and average annual percent change (AAPC) with 95% confidence intervals (CI) were calculated using Joinpoint regression analysis.

Results: From 1999 to 2020, there were 575,343 reported deaths due to GI bleeding among older adults in the U.S., with an overall declining trend in AAMRs (AAPC = -1.56). AAMRs decreased significantly from 82.7 in 1999 to 55 in 2009 (APC = -4.23, 95% CI: -4.95 to -3.71), remained stable from 2009 to 2018 (APC = -0.05, 95% CI: -1.78 to 0.69), but rose significantly to 63 in 2020 (APC = 5.42, 95% CI: 1.43 to 7.46). Throughout the study period, males had a higher AAMRs than females (75.4 vs 53.1), with comparable declines in mortality (AAPC: -1.56 vs. -1.52). Racial disparities were notable, with the highest AAMR among Non-Hispanic Black or African American (76.4) and the lowest among Non-Hispanic Asian or Pacific Islanders (46.4). Mortality rates were higher in non-metropolitan areas (72.4%) than in metropolitan areas (60.1%). Regionally, the Midwest and Northeast (65.8) exhibited the highest AAMRs, while Vermont (88.7) and West Virginia (86.1) had the highest state-level rates; Arizona (44.7) and Georgia (44.4) had the lowest.

Discussion: While overall mortality from GI bleeding among older adults has declined over the past two decades, significant disparities persist across sex, race, and geographic regions, with recent data indicating a concerning rise in mortality. These patterns highlight a need for targeted public health policies and medical strategies to improve access to preventive and therapeutic care.


Figure: Central Illustration: Trends and Disparities in Gastrointestinal Bleeding Mortality Among Older Adults in the U.S. (1999-2020)

Disclosures:
Ramish Hannat indicated no relevant financial relationships.
Ayesha Mubbashir indicated no relevant financial relationships.
Bisher Sawaf indicated no relevant financial relationships.
Amin Abu Hejleh indicated no relevant financial relationships.
Komail Khalid Meer indicated no relevant financial relationships.
Amine Rakab indicated no relevant financial relationships.
Sneha Vijay indicated no relevant financial relationships.
Muhammad Hamza Shuja indicated no relevant financial relationships.
Ahmad Shahid indicated no relevant financial relationships.
Huda Ahmed indicated no relevant financial relationships.

Ramish Hannat, MD¹, Ayesha Mubbashir, MD², Bisher Sawaf, MD³, Amin Abu Hejleh, MD⁴, Komail Khalid Meer, MD², Amine Rakab, MD⁵, Sneha Vijay, MD², Muhammad Hamza Shuja, MD⁶, Ahmad Shahid, MD⁷, Huda Ahmed, MD⁸. P5221 - Trends and Disparities in Gastrointestinal Bleeding Mortality Among Older Adults in the US (1999–2020), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.