Abstract
Introduction Non-alcoholic fatty liver disease (NAFLD) is a major cause of mortality and its association with liver cirrhosis remains underexplored. Understanding this relationship is essential to identifying high-risk populations and developing targeted public health interventions. Aims and objective To analyze mortality trends and demographic disparities in NAFLD with liver cirrhosis as a contributing cause using the Centres for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) Multiple Causes of Death (MCD) database from 1999 to 2020. Methodology A retrospective cross-sectional study was conducted using the CDC MCD database to assess mortality trends in individuals aged 25 years and older in the United States from 1999 to 2020. The study included deaths where NAFLD (ICD-10: K76.0) was listed as the underlying cause and liver cirrhosis (ICD-10: K74) as a contributing cause. Data were analyzed by age, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated. Results A total of 14,383 deaths were recorded. The AAMR for NAFLD with liver cirrhosis showed an increase from 1999 to 2006 with an APC of +20.66 (p<0.05), which further showed an increase between 2006 and 2009 with an APC of +27.60, and then again increased significantly from 2009 to 2020 with an APC of 15.87 (p<0.05). The highest mortality was observed in females, the white population, and metropolitan areas. Temporal trends showed an increase, with disparities noted across demographic and geographic factors. Conclusion This study highlights significant mortality trends (increasing) in NAFLD with liver cirrhosis, with disparities by gender, race, and location. The findings underscore the need for targeted prevention strategies and improved healthcare access.