Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050: Comprehensive Analysis of the WHO Mortality Database

Jong Woo Hahn, Selin Woo, Jaeyu Park, Hyeri Lee, Hyeon Jin Kim, Jae Sung Ko, Jin Soo Moon, Masoud Rahmati, Lee Smith, Jiseung Kang, Damiano Pizzol, Mark A Tully, Elena Dragioti, Guillermo F. López Sánchez, Kwanjoo Lee, Yeonjung Ha, Jinseok Lee, Hayeon Lee, Sang Youl Rhee, Yejun SonSoeun Kim, Dong Keon Yon

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.

Methods
This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-period-cohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.

Results
The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older. Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.

Conclusion
Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

Original languageEnglish
Article numbere291
Pages (from-to)1-14
Number of pages14
JournalJournal of Korean Medical Science
Volume39
Issue number46
Early online date20 Sept 2024
DOIs
Publication statusPublished (in print/issue) - 2 Dec 2024

Bibliographical note

Publisher Copyright:
© 2024 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Data Access Statement

The WHO Mortality Database represents a worldwide cooperative collection of death rates as reported by member countries of the WHO. Dong Keon Yon (yonkkang@gmail. com) was contacted for the study protocols and statistical codes. Access to the dataset was provided by the WHO under a data-use agreement.

Keywords

  • Liver Disease
  • Mortality
  • WHO Mortality Database
  • Global Trend
  • Prediction Model
  • World Health Organization
  • Global Health
  • Humans
  • Middle Aged
  • Liver Diseases/mortality
  • Male
  • Mortality/trends
  • Bayes Theorem
  • Female
  • Adult
  • Aged
  • Databases, Factual

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