S1176 A Retrospective Analysis of Mortality Due To Paralytic Ileus and Intestinal Obstruction Without Hernia in the United States From 1999 to 2023 Using the CDC WONDER Database

Introduction: Paralytic ileus and intestinal obstruction remained major causes of mortality, particularly in the elderly patients, often following surgery, malignancy, or malabsorption. The objective of this study is to investigate trends in mortality related to paralytic ileus and intestinal obstruction without hernia among United States (US) adults aged ≥45 during the years 1999–2023. Methods: This retrospective study used death certificate data from the CDC WONDER database (1999-2023), focusing on paralytic ileus and intestinal obstruction without hernia (International Classification of Diseases-10: K56) as the underlying cause of death among US adults aged 45 and over. Age-adjusted mortality rates (AAMRs) were calculated and examined using Joinpoint regression analysis to estimate the Annual Percent Change (APC), with 95% confidence intervals and a significance threshold of P < 0.05. Trends were analyzed across demographic factors including sex, race/ethnicity (Hispanic and non-Hispanic), and 2013 urbanization, as well as geographic variables such as US Census regions and states. Results: Paralytic ileus and intestinal obstruction without hernia caused 151,597 deaths in adults aged ≥45 years between 1999 and 2023, with a mean age-adjusted mortality rate (AAMR) of 5.05 per 100,000 (95% CI: 5.03–8.06). Males and Females showed a comparable mean AAMR of 5.01 and 5.03, respectively. Since 2017, mortality has significantly increased among both Hispanic or Latino (APC: 2.66%, 95% CI: 0.46–8.59) and Non-Hispanic populations (APC: 3.25%, 95% CI: 2.39–4.48). From 1999 to 2017, Black or African American individuals showed a significant decline in mortality (APC: –1.32, 95% CI: –1.93 to –0.86, P < 0.001), followed by a sharp increase from 2017 to 2023 (APC: 4.15, 95% CI: 2.19 to 8.14, P < 0.001). Post-2017, a significant upward trend in mortality was observed in CENS-R1: Northeast (2020–2023, APC: 5.67; 95% CI: 2.60–10.76), CENS-R2: Midwest (2019–2023, APC: 2.77; 95% CI: 0.10–7.63), CENS-R3: South (2018–2023, APC: 3.69; 95% CI: 2.52–5.62), and CENS-R4: West (2017–2023, APC: 2.29; 95% CI: 0.49–7.39). State-level variation was also notable with the highest AAMRs observed in North Dakota (6.84), while the lowest were reported in California (3.2). Conclusion: Mortality from paralytic ileus and intestinal obstruction has risen significantly across geographic and demographic groups since 2017, particularly census regions and Hispanic origin, highlighting the need for targeted public health strategies.