Muhammad Shahzad, Syeda Sundus Shah Bokhari, Fnu Rabia, Amna Zaman Khan, Muhammad Abdullah Ali, Ali Hashim, Farah Shahzad, Maryam Tariq, Zarhaish Barkat-Ullah, Malaika Rasheed, Muhammad Uzair Khan Niazi, Ali Hassan, Asfand Yar Khan, Taha Mazhar Awan, Saad Ahmed Waqas, Raheel Ahmed
{"title":"1999年至2020年美国成年人肝纤维化和肝硬化相关死亡率的趋势和人口统计学：一项CDC的奇迹分析","authors":"Muhammad Shahzad, Syeda Sundus Shah Bokhari, Fnu Rabia, Amna Zaman Khan, Muhammad Abdullah Ali, Ali Hashim, Farah Shahzad, Maryam Tariq, Zarhaish Barkat-Ullah, Malaika Rasheed, Muhammad Uzair Khan Niazi, Ali Hassan, Asfand Yar Khan, Taha Mazhar Awan, Saad Ahmed Waqas, Raheel Ahmed","doi":"10.1002/jgh3.70247","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Liver cirrhosis, the fifth leading cause of adult mortality, involves progressive, irreversible liver fibrosis and loss of function. Its rising prevalence necessitates studying trends, identifying high-risk groups, and enhancing preventive strategies. This study aims to assess temporal trends and demographic disparities in liver fibrosis and cirrhosis-related mortality in the United States from 1999 to 2020.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Death certificates from the CDC WONDER(Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database for 1999–2020 were analyzed for liver fibrosis and cirrhosis-associated mortality in adults > 25 years. AAMRs per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.3.0.0) calculated annual percent change (APC) and average APC (AAPC), identifying significant trends (<i>p</i> < 0.05, two-tailed <i>t</i> test).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From 1999 to 2020, 787 375 liver cirrhosis-related deaths occurred in adults > 25. AAMR increased from 16.61 (1999) to 18.93 (2020). Men had a higher AAMR (21.51; 95% CI: 21.44 to 21.57) than women (11.73; 95% CI: 11.68 to 11.77). AAMRs were highest in Non-Hispanic (NH) American Indian (26.42; 95% CI: 25.91 to 26.93) followed by Hispanics (24.93; 95% CI: 24.77 to 25.09), NH White (16.71; 95% CI: 16.67 to 16.75), NH Black (15.13; 95% CI: 15.02 to 15.24), and NH Asian/Pacific Islander (9.29; 95% CI: 9.15 to 9.42). By region, the South had the highest AAMR (18.87; 95% CI: 18.8 to 18.93), followed by the West (15.75; 95% CI: 15.67 to 15.82), Midwest (14.55; 95% CI: 14.47 to 14.62), and Northeast (14.17; 95% CI: 14.1 to 14.25). Micropolitan (Nonmetro) areas had the highest AAMR (17.62; 95% CI: 17.49 to 17.74), while Large Fringe Metro Areas had the lowest AAMR (14.2; 95% CI: 14.13 to 14.27). Texas reported the highest AAMR (25.7); Nebraska reported the lowest (9.4).</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>Liver cirrhosis-related mortality has risen since 1999, especially among Hispanic adults, men, and those in Southern or nonmetropolitan regions. Targeted prevention is needed to reduce mortality in these high-risk groups.</p>\n </section>\n </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 10","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70247","citationCount":"0","resultStr":"{\"title\":\"Trends and Demographics of Liver Fibrosis and Cirrhosis-Related Mortality Among Adults Living in the United States From 1999 to 2020: A CDC Wonder Analysis\",\"authors\":\"Muhammad Shahzad, Syeda Sundus Shah Bokhari, Fnu Rabia, Amna Zaman Khan, Muhammad Abdullah Ali, Ali Hashim, Farah Shahzad, Maryam Tariq, Zarhaish Barkat-Ullah, Malaika Rasheed, Muhammad Uzair Khan Niazi, Ali Hassan, Asfand Yar Khan, Taha Mazhar Awan, Saad Ahmed Waqas, Raheel Ahmed\",\"doi\":\"10.1002/jgh3.70247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Liver cirrhosis, the fifth leading cause of adult mortality, involves progressive, irreversible liver fibrosis and loss of function. Its rising prevalence necessitates studying trends, identifying high-risk groups, and enhancing preventive strategies. This study aims to assess temporal trends and demographic disparities in liver fibrosis and cirrhosis-related mortality in the United States from 1999 to 2020.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Death certificates from the CDC WONDER(Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database for 1999–2020 were analyzed for liver fibrosis and cirrhosis-associated mortality in adults > 25 years. AAMRs per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.3.0.0) calculated annual percent change (APC) and average APC (AAPC), identifying significant trends (<i>p</i> < 0.05, two-tailed <i>t</i> test).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>From 1999 to 2020, 787 375 liver cirrhosis-related deaths occurred in adults > 25. AAMR increased from 16.61 (1999) to 18.93 (2020). Men had a higher AAMR (21.51; 95% CI: 21.44 to 21.57) than women (11.73; 95% CI: 11.68 to 11.77). AAMRs were highest in Non-Hispanic (NH) American Indian (26.42; 95% CI: 25.91 to 26.93) followed by Hispanics (24.93; 95% CI: 24.77 to 25.09), NH White (16.71; 95% CI: 16.67 to 16.75), NH Black (15.13; 95% CI: 15.02 to 15.24), and NH Asian/Pacific Islander (9.29; 95% CI: 9.15 to 9.42). By region, the South had the highest AAMR (18.87; 95% CI: 18.8 to 18.93), followed by the West (15.75; 95% CI: 15.67 to 15.82), Midwest (14.55; 95% CI: 14.47 to 14.62), and Northeast (14.17; 95% CI: 14.1 to 14.25). Micropolitan (Nonmetro) areas had the highest AAMR (17.62; 95% CI: 17.49 to 17.74), while Large Fringe Metro Areas had the lowest AAMR (14.2; 95% CI: 14.13 to 14.27). Texas reported the highest AAMR (25.7); Nebraska reported the lowest (9.4).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion</h3>\\n \\n <p>Liver cirrhosis-related mortality has risen since 1999, especially among Hispanic adults, men, and those in Southern or nonmetropolitan regions. Targeted prevention is needed to reduce mortality in these high-risk groups.</p>\\n </section>\\n </div>\",\"PeriodicalId\":45861,\"journal\":{\"name\":\"JGH Open\",\"volume\":\"9 10\",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70247\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JGH Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jgh3.70247\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JGH Open","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jgh3.70247","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Trends and Demographics of Liver Fibrosis and Cirrhosis-Related Mortality Among Adults Living in the United States From 1999 to 2020: A CDC Wonder Analysis
Introduction
Liver cirrhosis, the fifth leading cause of adult mortality, involves progressive, irreversible liver fibrosis and loss of function. Its rising prevalence necessitates studying trends, identifying high-risk groups, and enhancing preventive strategies. This study aims to assess temporal trends and demographic disparities in liver fibrosis and cirrhosis-related mortality in the United States from 1999 to 2020.
Methods
Death certificates from the CDC WONDER(Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database for 1999–2020 were analyzed for liver fibrosis and cirrhosis-associated mortality in adults > 25 years. AAMRs per 100 000 were stratified by year, sex, race/ethnicity, and region. Joinpoint Regression (v5.3.0.0) calculated annual percent change (APC) and average APC (AAPC), identifying significant trends (p < 0.05, two-tailed t test).
Results
From 1999 to 2020, 787 375 liver cirrhosis-related deaths occurred in adults > 25. AAMR increased from 16.61 (1999) to 18.93 (2020). Men had a higher AAMR (21.51; 95% CI: 21.44 to 21.57) than women (11.73; 95% CI: 11.68 to 11.77). AAMRs were highest in Non-Hispanic (NH) American Indian (26.42; 95% CI: 25.91 to 26.93) followed by Hispanics (24.93; 95% CI: 24.77 to 25.09), NH White (16.71; 95% CI: 16.67 to 16.75), NH Black (15.13; 95% CI: 15.02 to 15.24), and NH Asian/Pacific Islander (9.29; 95% CI: 9.15 to 9.42). By region, the South had the highest AAMR (18.87; 95% CI: 18.8 to 18.93), followed by the West (15.75; 95% CI: 15.67 to 15.82), Midwest (14.55; 95% CI: 14.47 to 14.62), and Northeast (14.17; 95% CI: 14.1 to 14.25). Micropolitan (Nonmetro) areas had the highest AAMR (17.62; 95% CI: 17.49 to 17.74), while Large Fringe Metro Areas had the lowest AAMR (14.2; 95% CI: 14.13 to 14.27). Texas reported the highest AAMR (25.7); Nebraska reported the lowest (9.4).
Discussion
Liver cirrhosis-related mortality has risen since 1999, especially among Hispanic adults, men, and those in Southern or nonmetropolitan regions. Targeted prevention is needed to reduce mortality in these high-risk groups.
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