S1333 Shifting Patterns in Gastrointestinal Bleeding Mortality: Insights From a 20-Year US Study

Introduction: Gastrointestinal bleeding (GIB) is a common cause of hospitalization in the United States, with sources originating from the upper or lower gastrointestinal tract. This study aimed to evaluate national trends in GIB-related mortality from 1999 to 2020, stratified by sex, race, and region to identify shifting demographic patterns. Methods: Mortality data was extracted from CDC WONDER and stratified by sex, race, and U.S. Census region. The findings were reported as age-standardized mortality rates. We used Joinpoint regression analysis (v5.20) to compute the annual percentage change (APC) and average annual percentage change (AAPC) for each subgroup, with significance set at P < 0.05. Results: Among women, GIB mortality declined significantly between 2003-2007 (APC: -5.36%, P < 0.05), then remained stable through 2018, then increased from 2018-2020 (APC: 4.10%, P < 0.05). Among men, there was a significant decrease in GIB from 2001-2009 with an APC of -3.08% (P < 0.05). Similar to women, men experienced an overall decline in mortality from 1999 to 2020. By race, American Indians saw a consistent decline (APC of -1.55%, P < 0.05). Mortality decreased for Blacks from 1999-2010 (APC of -2.94%, P < 0.05) and then stabilized from 2010 to 2020. Among Whites, there was a significant increase in GIB mortality rates from 2009 to 2020 with an APC of 1.03% (P < 0.05).We also examined the trends in mortality rates by region. In the Northeast, there was a significant increase in GIB from 2009 to 2020 with an APC of 0.84% (P < 0.05). Similarly in the West, from 2018 to 2020 there was a sharp increase in GIB with an APC of 6.72% (P < 0.05). GIB mortality rates in the South and Midwest showed non-significant declines over the full period. Conclusion: GIB-related mortality has shown varying trends across sex, race, and region over the past 2 decades in the US. While the overall GIB mortality rates have declined among both sexes, there have been recent increases in GIB rates among women, Whites, and the Northeast and West regions. These subgroup-specific disparities highlight the need for renewed surveillance and targeted interventions to prevent worsening outcomes.