S3171 Rising Mortality Rates of Gastric Ulcer in the United States From 1999 to 2020: CDC WONDER Analysis

Introduction: Gastric ulcer significantly impacts the health and quality of life of elderly patients. Gaining insight into its trends is essential for developing effective interventions and enhancing treatment strategies. The aim of our study was to evaluate mortality trends related to gastric ulcers among adults aged 65 years and above in the United States. Methods: An analysis of the CDC WONDER database was conducted, focusing on death certificate data from 1999 to 2020. Specifically, gastric ulcer-related mortality was examined among adults aged 65 years and older. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 persons with 95% confidence interval (CIs), adjusting for variables including year, sex, race, and geographic location. Results: Between 1999 to 2020, gastric ulcer-related deaths amounted to 34,795. Majority of the deaths occurred in medical facilities (69.2%) followed by decedents’ homes (13.2%) and nursing home/long term care facilities (12.3%). The AAMR reduced significantly from 6.6 in 1999 to half its value (3.3) in 2008 (APC -7.43; 95% CI -7.98 to -6.89). The decline continued, reaching 2.8 in 2015 (APC -2.58; 95% CI -4.27 to -0.85) after which an increase in AAMR was seen until 3.4 in 2020 (APC 3.39; 95% CI 1.1 to 5.72). Men had a higher overall AAMR than women (AAMR men: 4.1; 95% CI 4 to 4.1; vs women: 3.6; 95% CI 3.5 to 3.6). Non-Hispanic (NH) Asian or Pacific Islander and NH Black or African American had the joint highest AAMR (4.0) followed by NH White (3.7) and Hispanic (3.2). NH American Indian or Alaska were not included due to unreliable data. The West (4.9) had the highest AAMR followed by the Midwest (4.0), South (3.3) and Northeast (3.1). California, Washington, Iowa, Hawaii, and the District of Columbia were in the top 90th percentile for AAMR while Arizona, Louisiana, Connecticut, Florida, and Massachusetts fell in the bottom 10th percentile. Urban and rural regions had similar overall AAMRs (AAMR urban: 3.7; 95% CI 3.7 to 3.8; vs rural: 4.1; 95% CI 4.0 to 4.2). Conclusion: Disparities were observed among males, NH Asians and Blacks, and patients living in the Western region of the United States. Further research is needed to understand the underlying factors to help develop preventative strategies.