National Patterns of Hernia Mortality,1999-2023: Insights From the CDC WONDER Database

Abstract

Background

Hernia is common and treatable, yet deaths persist nationally. Long-term trends and disparities through 2023, including the COVID-19 period—are not fully described.

Methods

Using the Centers for Disease Control and Prevention’s Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database, we analyzed U.S. resident deaths with ICD-10 K40–K46 as underlying cause (1999-2023). Age-adjusted mortality rates (AAMRs, per 100 000) were standardized to the 2000 U.S. population. Temporal patterns were summarized with joinpoint average annual percent change (AAPC). Subgroups included sex, age, race/ethnicity, Census region, 2013 NCHS urbanization (to 2020), and hernia subtypes.

Results

There were 47 248 hernia deaths; annual deaths rose from 1396 to 2617 (+87.46%). Overall AAMR increased from 1.02 to 1.23 (AAPC +0.91%). AAMRs rose for both females and males and remained elevated after 2019, with a 2020-2021 rise and subsequent stabilization. In 2023, AAMR was higher in non-Hispanic White (1.32) than in non-Hispanic Black (1.09) and Hispanic (0.99) populations, and varied by region (Northeast 1.27, Midwest 1.34, South 1.10, and West 1.30). Urbanization gradients persisted through 2020 (nonmetropolitan ≈1.22 vs metropolitan 0.99). Rates increased steeply with age. By subtype, deaths and/or AAMR increased for inguinal, diaphragmatic, unspecified abdominal, ventral, and umbilical hernias (eg, inguinal deaths 179 to 392, +118.99%); femoral AAMR declined, and deaths from other abdominal hernia decreased.

Conclusions

U.S. hernia mortality shows a growing absolute burden and modest AAMR increase, alongside persistent disparities and heterogeneous subtype trajectories. Subtype-aware surveillance, resilient elective capacity, and equitable emergency pathways may help reduce preventable deaths.