Forecasting Alcohol-Related Liver Disease Mortality Trends in Younger Populations Using Advanced Time-Series Models: A 1999-2030 Analysis.

Objective: Alcohol-related liver disease (ALD) has emerged as a significant public health concern, particularly among younger populations. ALD remains the leading cause of alcohol-attributable deaths. This study aims to forecast ALD mortality trends up to 2030, focusing on individuals under 55 years. Methods: We utilized data from the CDC WONDER database (1999-2022) to examine ALD-related deaths, identified by ICD-10 codes (K70.0-K70.9). Crude mortality rates (CMRs) per 100 000 were analyzed and temporal trends were assessed using annual and average annual percent changes (APC/AAPC) with empirical quantile confidence intervals. An Autoregressive Integrated Moving Average (ARIMA) model was employed to project mortality rates until 2030, validated through time series cross-validation. Results: From 1999 to 2022, there were 181 862 ALD-related deaths among individuals under 55, with mortality rates increasing from 3.9 per 100 000 in 1999 to 9.7 per 100 000 in 2022 (AAPC 4.66%, 95% CI: 3.90%-5.86%). Projections suggest rates will continue to rise, reaching 14.4 per 100 000 by 2030. From 1999 to 2022, the 25-34 age group experienced the highest increase, with an AAPC of 10.27% (95% CI: 9.19%-11.35%), while the 35-44 and 45-54 age groups showed more moderate increases, with AAPCs of 5.03% and 4.38%, respectively. Projections indicate an AAPC of 3.86% for ages 25-34, 3.90% for ages 35-44, and 6.17% for ages 45-54 by 2030. Conclusion: Forecasts indicate a continued rise in ALD mortality among individuals under 55, necessitating immediate public health strategies to mitigate this trend.