Research found that there was a widened age disparity in gastrointestinal (GI) bleeding-related deaths in the post-pandemic era, putting young men at highest risk, Xu Gao, MD, explained during her presentation at the Digestive Disease Week (DDW) 2023 in Chicago.

Dr Gao is a gastroenterologist with the Xi'an Jiaotong University in Xi’an, China.

“There were significantly increased trends in both middle- and young-aged groups, with the young-aged showing the steepest upward trend,” Dr Gao explained during the COVID and clinical practice session.

The team analyzed 646,508 GI bleeding-related deaths occurred between January 2010 and December 2021, using the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) website of the National Vital Statistic System. Patients between 19-44 years were classified as young, between 45-64 years as middle-aged, and more than 65 years as old-aged. The researchers compared the death trends across age groups before and during the pandemic.

The highest mortality rate (73%) was seen in the old-age population. The mortality rate decreased with age. From the recorded deaths, more than half of the patients (51%) were men. The trends between sexes remained similar pre-pandemic vs during the pandemic.

Before the pandemic, the old-age group “had a slight but significant decreasing trend for GIB-related mortality with an annual percentage change of -0.4 (95%CI -0.8 to -0.1), P=0.031,” Dr Gao said. However, there was a significant upward trend for young and middle-aged groups, with the younger group showing the steepest upward trend. “During the pandemic, the young-aged group demonstrated the most pronounced increasing trend, with age-standardized mortality rates increasing from 1.43 (per 100,000 population) to 2.51 in 2020 and 3.00 in 2021, correlating to a 30.6% excess death in 2020 and 47.1% in 2021,” Dr Gao said.

GI bleeding, known to incur high morbidity and mortality rates, requires early diagnosis and timely management. Compared to younger patients, older patients are more likely to suffer from death due to GI bleeding. Similarly, men are more likely to suffer from adverse effects of GI bleeding than women. With the pandemic, the age and gender variables shifted. “Our population-based study showed an age disparity in GI bleeding-related mortality before the pandemic and emphasized during the pandemic, with the greatest impact on young males,” Dr Gao said. “With 35.80% and 53.05% excess mortality in 2020 and 2021, the young male group was hit the hardest.”

—Priyam Vora

Reference:
Gao X. Presentation # Sa1061: Impact of the COVID-19 pandemic on the age and sex disparity in the mortality rate of gastrointestinal bleeding in the United States: A population-based study. Digestive Disease Week 2023. Chicago, Illinois.