P3771 - Age Standardized Incidence and Mortality Rates of Chronic Liver Disease in the United States From 1990-2019: State Level Analysis From the Global Burden of Disease

Chun-Wei Pan, MD¹, Sania Saleem, MD¹, Bashar Attar, MD², Sultan Mahmood, MD^3
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²Cook County Health, Chicago, IL; ³Beth Israel Deaconess Medical Center, Boston, MA

Introduction: Chronic liver disease remains one of the top ten causes of death in the adult populations of the United States. Although CLD has been examined globally, we lack detailed data on its impact at the state level in the US, considering the varied demographics. We aimed to analyze the trends of age-standardized incidence and mortality rates of CLD with its various etiologies in different states of the United States.

Methods: Using the global burden of disease data, we analyzed the trend of incidence and mortality of CLD in the United States between 1990-2019. This included a State-level analysis to determine the demographic variation across the United States. Relative percentage change in age-standardized (ASR) incidence and mortality rates during this period was calculated.

Results: In 2019, the US saw 90,854 new CLD cases and 67,286 deaths, respectively, reflecting a 38.0% and 80.0% increase from 1990. From 1990-2019, there was a 10.7% rise in the age-standardized rate (ASR) of new CLD cases and a 5.6% increase in the ASR death rate. In 2019, the highest incidence rates were in New Mexico (34.6/100,000), Nevada (33.8/100,000), and West Virginia (31.1/100,000). Notably, the most significant increase in new cases over our study period was seen in West Virginia (28.5%), Oklahoma (22.6%), and Tennessee (22.4%). As stratified by etiology, alcohol incidence rise was notable in Indiana (26.5%) and Tennessee (19.0%).

In terms of ASR mortality, the average in the United States was 13.2/100,000, while the highest was seen in New Mexico (24.9), Nevada (17.0), and West Virginia (17.0), similarly highest relative percentage change in ASR mortality was seen in New Mexico and West Virginia, with 53.9% and 44.8% respectively. By etiologies, hepatitis C and NAFLD showed an uptick of 23.1% and 9.2%, respectively. While the highest percentage increase in our study period was in Oklahoma (84.2%), followed by West Virginia (71.1%)



Discussion: There has been a constant rise in the incidence and mortality of CLD across the United States. The disease burden due to Hepatitis B has significantly decreased, but the percentage increase in the ASR of incidence and mortality of hepatitis C and NAFLD-related CLD has been rising. There is considerable variation across states, underlining the need for localized strategies. Despite efforts to manage hepatitis, more focused actions should be taken to address alcohol use, obesity, and the continued challenge of Hepatitis C.



Disclosures:


Chun-Wei Pan, MD¹, Sania Saleem, MD¹, Bashar Attar, MD², Sultan Mahmood, MD³. P3771 - Age Standardized Incidence and Mortality Rates of Chronic Liver Disease in the United States From 1990-2019: State Level Analysis From the Global Burden of Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.