Analysis of the Death Surveillance Database in China from 2008 to 2020

Cirrhosis is the terminal stage of various chronic liver diseases and seriously affects the quality of life and life expectancy of patients. China has an important role in the global burden of cirrhosis and other chronic liver diseases, accounting for 14.9% of the world’s total cases.

Thus, the mortality of cirrhotic patients in China has a greater effect on the global burden of cirrhosis and other chronic liver diseases. It was necessary for us to analyze the current mortality of patients with cirrhosis and its changing trends over the past decades in China to establish intervention strategies and reduce the mortality burden of patients with cirrhosis worldwide.

In this study, using data from the Disease Surveillance System (DSPs) of the Chinese Center for Disease Control and Prevention (CDC), we analyzed the mortality profile of cirrhosis in 2020 and the mortality trend from 2008 to 2020, stratified by gender, location, region, province and age group.

Mortality data from 2008 to 2020 were retrieved from the Disease Surveillance System (DSP) of the Chinese Center for Disease Control and Prevention. Crude death rates and age-standardized death rates (deaths due to cirrhosis/100,000 people, 1/100,000) are reported by sex, age (<40, 40–85 и >85 years), location (urban and rural) and region (Eastern China, Central China and Western China).

Age-standardized death rates were calculated using two age structures: the 2010 Population Census of China (ASMRC) and Segi World Population (ASMRW). We also analyzed the changing trend of cirrhosis mortality from 2008 to 2020 by sex, location, and region by estimating the ASMRC average annual percentage change (AAPC) and its 95% confidence interval (CI).

The overall death rate from cirrhosis was 4.57 per 100,000 people in 2020. Compared with women and people living in urban areas, men and people living in rural areas had a higher age-standardized death rate. The total death rate and age-standardized death rate in the provinces in southwest China (Guangxi, Yunnan, Guizhou, and Qinghai) were higher than those in other provinces. Furthermore, as age increases, the age-specific mortality increases significantly. From 2008 to 2020, cirrhosis mortality in China decreased except for men aged 50–59 years, women aged 45–49 years and women aged 80–84 years.

We analyzed data on cirrhosis mortality between 2008 and 2020 in China using data extracted from the CDC-DSP. In these 13 consecutive years, cirrhosis mortality has decreased in China, except for men 50-59 and women 45-49 and 80-84. Greater mortality from cirrhosis was observed in men, older individuals, and people living in rural areas and provinces in Southwest China. In the future, healthcare providers should pay more attention to these people during the intervention and control of cirrhosis mortality.

The work was published in Journal of Clinical and Translational Hepatology.