(437) A Rise in Liver-Related Mortality in the United States Over Last Two Decades: Was It Preventable?

Introduction: Globally, liver disease is responsible for 2 million deaths annually, of which 2/3rd are men. Surveillance report published by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) in 2019 reported 47,919 deaths due to liver disease in the US, 50.3% were alcohol-related. We aim to explore the trend of liver disease mortality over 21 years from 2001 to 2021 in the United States and its future implications.

Methods: Data were extracted from the Centers for Disease Control and Prevention’s (CDC) Web-Based Injury Statistics Query and Reporting System (WISQARS) to compare liver disease mortality over 21 years from 2001 to 2021. Mortality data is reported in numbers, crude death rate (CDR), and percentage. Percentage mortality is defined as the number of deaths caused by liver disease compared to all-cause mortality. CDR is the number of deaths per 100,000 estimated population at midyear. Our results were limited by a single source, not including any other registries.

Results: Hepatic mortality was responsible for 746,737 deaths over 21 years. Hepatic mortality has consistently risen in United States over past two decades. In 2001, liver disease caused 27,035 (1.3%, CDR 9.5) deaths. This number steadily increased to 33,642 (1.6%, CDR 10.8) in 2011. Over the next ten years, liver disease mortality grew to 56,585 (2%, CDR 17) in 2021, representing a 109.3% rise in total mortality. Also, there was an increase in mortality in the age groups 25-34 and 35-44, respectively. Similar rising trends were seen in males and females, respectively. We used Kolmogorov-Smirnov (K-S) Test of Normality to authenticate that our analysis matches the characteristics of a normal distribution. Our SD was 8506, Skewness was 0.98, Kurtosis was 0.42, K-S test statistic (D) was very low= 0.155, $ p-value=64, signifying that our analysis of 21 years didn't diverge from normal distribution despite rising trend.

Conclusions: Our analysis shows an increase in mortality due to liver disease across the United States, with a shift towards Nonalcoholic fatty liver (NAFLD) & alcoholic liver diseases over viral hepatitis. Liver disease is mainly attributed to reversible causes. An emphasis on primary care and a focus on providing education to reverse these causes may be the key to reducing liver mortality in the future.