S2813 Trends and Disparities in Liver Disease and Chronic Ischemic Heart Disease-Related Mortality in Adults ≥65 Years From 1999 to 2023 in the United States

Introduction: The relationship in terms of mortality between liver disease (LD) and chronic ischemic heart disease (CIHD) is poorly understood. Trend analysis stratified by demographic and geographic categorization concerning LD and CIHD-related mortality within the United States has not been done before. This study analyzes national LD and CIHD-related mortality trends among adults ≥65 years from 1999 to 2023. Methods: The CDC WONDER Multiple-Cause-of-Death dataset (1999–2023) was used to assess mortality trends in adults ≥65 years using International Classification of Diseases, Tenth Revision (ICD-10) codes for LD (K70-K76) and CIHD (I25). Data were stratified by year, along with demographic and geographic classifications. Age-adjusted mortality rates (AAMR) were quantified per 100,000 persons with 95% confidence intervals (95%CI). Average annual percent change (AAPC) was calculated via the Joinpoint regression model, with statistical significance defined as P < 0.05. Results: A total of 102,423 LD and CIHD-related deaths occurred from 1999 to 2023. Overall AAMR rose from 10.1 in 1999 to 12.6 in 2023 (AAPC: 0.8; 95%CI: 0.6 to 1.1). Men had higher average AAMR compared to women, and had a higher rate of increase (AAPC men: 0.9; 95%CI: 0.7 to 1.1, AAPC women: 0.4; 95%CI: 0.1 to 0.6). Hispanic/Latinos had the highest average AAMR and had stable rates, compared to increasing rates for non-Hispanic (NH) Whites (AAPC: 1.1; 95%CI: 0.9 to 1.3) and NH Black/African Americans (AAPC: 0.7; 95%CI: 0.3 to 1.1). Conversely, NH Asian/Pacific Islanders saw declining rates (AAPC: -2.1; 95%CI: -3.5 to -0.8). The West had the highest average AAMR and had stable rates, compared to increasing rates for the South (AAPC: 1.7; 95%CI: 1.4 to 2.0) and the Midwest (AAPC: 1.0; 95%CI: 0.7 to 1.4). Inversely, the Northeast saw declining rates (AAPC: -0.6; 95%CI: -1.0 to -0.3). From 1999 to 2020, rural areas had higher average AAMR and saw increasing rates (AAPC: 1.4; 95%CI: 0.9 to 1.8), while urban areas had stable rates. Conclusion: Liver fibrosis/cirrhosis and sepsis-related mortality rates among adults ≥65 years increased significantly from 1999 to 2023, with key disparities across demographic and geographical classifications. These disparities highlight the need for targeted interventions in high-risk populations so that mortality rates can decrease in the future.