(308) Mortality Trends of Acute Hepatitis Over 3 Decades: A Global Burden-of-Disease Study

Introduction: Acute viral hepatitis is a common cause of acute liver failure encountered in intensive care units (ICU), with its prevalence varying by geographical location [1]. For instance, viral hepatitis is the third most common cause of acute liver failure in developed countries but the leading cause in developing countries [2]. Acute viral hepatitis remains the most frequently identifiable indication of urgent liver transplants in patients with acute liver failure, without which patients have a low chance of survival [3]. Patients are often managed in the ICU given the high likelihood of fulminant deterioration [4]. Given the minimal progress in management of acute liver failure over the past 3 decades, we aimed to evaluate mortality trends in those with acute viral hepatitis in the USA over the past three decades.

Methods: Mortality trends of acute viral hepatitis across the US were evaluated through accessing the Global Burden of Disease 2019 database. Annual Percentage Change (APC) and average APC (AAPC) were calculated via JoinPoint Analysis Software. Results were stratified by age and gender.

Results: Between 1990 and 2019, there were a total of 136,344 deaths, of which 65.6% were identified in men. There was an overall decrement in the crude mortality rate, with the most significant decrease occurring between 2015 and 2016 (relative risk 0.83; Z= 6.94; p <.001) (figure 1). Deaths were more likely to occur in those older than 55 when compared to those between 18 and 54 years of age. The AAPC was -1.40 (95% CI -1.63 to -1.19; p < 0.001) in those 18 to 54 years old and -1.72 (95% CI -1.85 to -1.59; p < 0.001) in those above 55. No statistically significant difference in AAPC was noted between the two age groups. While both genders had a statistically significant decrease in AAPC in mortality, women were noted to have a higher decrement (AAPC –2.31; 95% CI -2.48 to -2.16; P < 0.001) than men (AAPC –1.51; 95% CI –1.78 to –1.29; P < 0.001).

Conclusions: Our findings indicate a general decline in mortality due to acute viral hepatitis over the past three decades. Men exhibited a consistently higher death rate and a smaller change in mortality trends compared to women.