Objective:

To quantify national temporal trends and disparities in deaths involving both digestive system malignant tumors (DSMTs) and liver failure among middle-aged and older adults in the United States.

Approach:

• Study Design: Population-based retrospective repeated cross-sectional study using CDC WONDER database.
• Data Analysis: Analyzed death records from 1999 to 2023 for patients aged ≥45 years with DSMTs, using ICD-10 codes.
• Mortality Rates: Calculated age-adjusted mortality rates (AAMRs) and assessed temporal trends using Joinpoint regression.

Key Findings:

• 82,796 liver failure-related deaths occurred among patients aged ≥45 years with DSMTs from 1999 to 2023.
• Annual deaths declined from 4,131 in 1999 to 3,250 in 2023 (−21.33%).
• AAMR decreased from 4.34 per 100,000 population (95% CI: 4.21–4.47) to 2.08 per 100,000 (95% CI: 2.01–2.15) (AAPC = −2.94%, 95% CI: −3.18 to −2.69).
• Males exhibited higher mortality than females, with increased deaths among Hispanic individuals.
• Geographic variation in mortality trends was noted, with some regions showing attenuated declines.

Interpretation:

Liver failure-related mortality among middle-aged and older patients with DSMTs has declined significantly over the past two decades, but improvements have slowed and remain uneven across different populations and regions.

Limitations:

• Study relies on death certificate data, which may have inaccuracies.
• Temporal trends may not account for all confounding factors affecting mortality.

Conclusion:

Liver failure-related mortality among middle-aged and older patients with DSMTs has declined significantly over the past two decades, but this improvement has slowed and remains uneven across populations and regions.

Sources:

• CDC WONDER