Iftikhar Areej, Alam Fatima Noor, Ashraf Danish Ali, Qureshi Saad Hassan, Akhtar Muzamil, Khan Ayesha Islam, Raza Muhammad, Qureshi Raheel, Ahmed Raheel
Department of Medicine Allama Iqbal Medical College Lahore Pakistan.
Department of Medicine Services Institute of Medical Sciences Lahore Pakistan.
JGH Open. 2025 Jul 8;9(7):e70205. doi: 10.1002/jgh3.70205. eCollection 2025 Jul.
Liver Cirrhosis is a growing cause of morbidity and mortality worldwide, but significant knowledge gaps remain regarding disparities in the place of patient death. This study aims to analyze the place of death trends for cirrhosis patients in the United States from 1999 to 2020, to direct preventive and palliative care measures.
In this descriptive study, death certificates were examined using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, using ICD codes K70.3, K71.7, and K74. The variables studied were the year, sex, age, race, rural-urban, census regions, and state. Percentages of deaths in each location were trended over time for interpretation.
Between 1999 and 2020, a total of 1 090 420 deaths were attributed to cirrhosis. The majority of these fatalities occurred in inpatient medical facilities (48.75%), followed by the decedent's home (25.71%). Men consistently exhibited higher deaths in all settings, especially in medical facility-inpatient settings (31.39%), and the highest deaths were for the 55-64 age group. NH White population reported the highest mortality in all places of death, whereas the South led mortality records among census regions. The least deaths occurred in non-core (non-metro) areas, and state-wise analysis revealed California to have the highest number of deaths (75 723), seconded by Texas (55 447).
Mortality due to cirrhosis increased gradually from 1999 to 2019, with a steep rise observed in 2019-2020. Men, the White race, 55-65 years age bracket, and residents of rural and Southern census regions reported the highest number of deaths from cirrhosis.
肝硬化在全球范围内导致发病和死亡的情况日益增多，但在患者死亡地点的差异方面仍存在重大知识空白。本研究旨在分析1999年至2020年美国肝硬化患者的死亡地点趋势，以指导预防和姑息治疗措施。
在这项描述性研究中，使用疾病控制和预防中心的广泛在线流行病学研究数据（CDC WONDER）数据库，通过国际疾病分类代码K70.3、K71.7和K74检查死亡证明。研究的变量包括年份、性别、年龄、种族、城乡、人口普查区域和州。对每个地点的死亡百分比随时间的变化趋势进行分析解读。
1999年至2020年期间，共有1090420例死亡归因于肝硬化。这些死亡大多发生在住院医疗设施（48.75%），其次是死者家中（25.71%）。在所有环境中，男性的死亡人数始终较高，尤其是在住院医疗设施环境中（31.39%），死亡人数最高的是55 - 64岁年龄组。非西班牙裔白人在所有死亡地点的死亡率最高，而在人口普查区域中，南部地区的死亡率最高。死亡人数最少的是在非核心（非都市）地区，按州分析显示加利福尼亚州的死亡人数最多（75723例），其次是得克萨斯州（55447例）。
1999年至2019年期间，肝硬化导致的死亡率逐渐上升，2019 - 2020年出现急剧上升。男性、白人种族、55 - 65岁年龄组以及农村和南部人口普查区域的居民肝硬化死亡人数最多。
