P3447 - Temporal Trends in Mortality Due to Acute Gastroenteritis and Cardiovascular Diseases Among US Adults: A 25-Year Analysis Using the CDC WONDER Database (1999-2023)

Dinesh Kumar, MBBS¹, Javeria Javeid, MBBS², Tabia Shujaat, MBBS¹, Fnu Kalpina, MBBS¹, Muhammad Nasir, MBBS³, Bakhtawar Haseeb, MBBS⁴,Wajeeh hassan, MBBS², Umar Hayat, MD⁵, Iman Waheed Khan, MD⁶
1Dow University of Health Sciences, Karachi, Sindh, Pakistan; 2Allama Iqbal Medical College, Lahore, Lahore, Punjab, Pakistan; 3Quaid-e-Azam Medical College Bahawalpur, Bahawalpur, Punjab, Pakistan; 4Jinnah Hospital Lahore, Lahore, Punjab, Pakistan; 5Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; 6Reading Hospital, Tower Health, Reading, PA

Introduction: In the United States (U.S.), approximately 5,000 deaths are estimated to occur annually due to acute gastroenteritis (AGE). Although frequently perceived as a self-limiting illness, its physiological stressors like hypotension, systemic inflammation, electrolyte imbalance can precipitate cardiac events. While cardiovascular disease (CVD) is the leading cause of mortality, understanding how AGE and CVD-related mortality intersect is vital for targeted public-health interventions.

Methods: We extracted 1999–2023 CDC WONDER multiple cause‑of‑death data for decedents ≥25 years focusing on the incidence of AGE and CVD-related age-adjusted mortality rates (AAMR) per 100,000 individuals. Joinpoint Regression v5.2.0 calculated annual percent changes (APC) with 95% CIs (p ≤ 0.05), stratified by year, sex, race, region, urbanization, and age group.

Results: A total of 193,991 deaths occurred due to AGE and CVD from 1999-2023. Overall, the AAMR significantly increased from 2.2 in 2001 to 4.2 in 2006 (APC: 14.06; p= 0.029), followed by stability in 2006 to 2012. Subsequently, a significant decline emerged from 4.2 in 2012 to 2.8 in 2019 (APC: -5.18; p= 0.002), with a recent upward trend to 3.1 by 2023 (APC: 2.07; p= 0.15). Men showed slightly higher AAMR than women (3.5 vs 3.4). Among women, the trend in mortality aligned with the overall trends [AAPC: 1.66; p< 0.001], while in men, mortality trends significantly increased from 1999 to 2007 (APC: 11.6; p< 0.001), followed by a sharp decline through 2023 (APC: -3.0; p< 0.001). Non-Hispanic (NH) American Indians had the highest AAMR (3.7), followed by NH White (3.6), NH Blacks (3.2), Hispanics (2.8) and NH Asians (1.7). The Northeast demonstrated the highest AAMR (3.9) among all regions, with urban areas slightly exceeding rural areas (3.6 vs 3.5, respectively). Among states, Rhode Island and Hawaii had the highest and lowest AAMR (7.0 and 1.5), respectively. Mortality rates were the highest in the 85+ age group over time. [AAPC: 0.54; p= 0.01].

Discussion: Our analysis indicates that males, non-Hispanic American Indians, and residents of Northeastern, metropolitan areas and geriatric populations bear the highest mortality burdens from AGE and cardiovascular disease. These disparities highlight the need for future research to find the exact correlation in vulnerable subgroups. Furthermore, effective interventions and treatment patterns should be explored to reduce the mortality burden in high-risk individuals.


Figure: Figure 1.
Temporal trends in age-adjusted mortality rates (AAMR) due to acute gastroenteritis and cardiovascular diseases among U.S. adults (1999–2023).
(A) Overall AAMR showing an initial rise, plateau, and subsequent decline followed by a modest increase in recent years.
(B) AAMR stratified by race, highlighting the highest mortality among non-Hispanic American Indians and the lowest among non-Hispanic Asians.
(C) AAMR stratified by sex, with males exhibiting slightly higher mortality than females across the study period.
(D) AAMR by age group, demonstrating consistently higher rates in the 85+ population with rising trends across all age groups over the last decade.


Disclosures:
Dinesh Kumar indicated no relevant financial relationships.
Javeria Javeid indicated no relevant financial relationships.
Tabia Shujaat indicated no relevant financial relationships.
Fnu Kalpina indicated no relevant financial relationships.
Muhammad Nasir indicated no relevant financial relationships.
Bakhtawar Haseeb indicated no relevant financial relationships.
Wajeeh hassan indicated no relevant financial relationships.
Umar Hayat indicated no relevant financial relationships.
Iman Waheed Khan indicated no relevant financial relationships.

Dinesh Kumar, MBBS¹, Javeria Javeid, MBBS², Tabia Shujaat, MBBS¹, Fnu Kalpina, MBBS¹, Muhammad Nasir, MBBS³, Bakhtawar Haseeb, MBBS⁴,Wajeeh hassan, MBBS², Umar Hayat, MD⁵, Iman Waheed Khan, MD⁶. P3447 - Temporal Trends in Mortality Due to Acute Gastroenteritis and Cardiovascular Diseases Among US Adults: A 25-Year Analysis Using the CDC WONDER Database (1999-2023), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.