Cause-specific mortality in patients with steatotic liver disease in the United States

Causes of death across the steatotic liver disease (SLD) spectrum remain incompletely characterized in routine clinical settings. In this large nationwide cohort study, we evaluated cause-specific mortality in patients with MASLD, MetALD, and ALD. We showed that cardiovascular disease and extrahepatic cancer were the primary causes of death in patients without cirrhosis across SLD subtypes, while liver disease and cardiovascular disease were predominant in those with cirrhosis. Importantly, MetALD and ALD were associated with progressively increasing risks of liver-related mortality compared to MASLD. Our findings highlight the need for integrated care models that simultaneously address cardiovascular risk factors, implement strategies to reduce alcohol consumption, and promote cancer screening to mitigate preventable deaths in SLD.