{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T21:06:50Z","timestamp":1777756010384,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hernia is common and treatable, yet deaths persist nationally. Long-term trends and disparities through 2023, including the COVID-19 period\u2014are not fully described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Centers for Disease Control and Prevention\u2019s Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database, we analyzed U.S. resident deaths with ICD-10 K40\u2013K46 as underlying cause (1999-2023). Age-adjusted mortality rates (AAMRs, per 100\u2009000) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 47\u2009248 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 \u22481.22 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251412265","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:48:28Z","timestamp":1766486908000},"page":"1686-1696","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["National Patterns of Hernia Mortality, 1999-2023: Insights From the CDC WONDER Database"],"prefix":"10.1177","volume":"92","author":[{"given":"Min","family":"Li","sequence":"first","affiliation":[{"name":"The First Hospital of Jilin University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-490X","authenticated-orcid":false,"given":"Yongan","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Affiliated Baoji Hospital of Xi'an Medical University, Weibin District, Baoji, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11489"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrad080"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011517.pub2"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000001071"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-025-03464-y"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-022-09327-2"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1242"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-025-11709-1"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac032"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.070923"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11746"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwae422"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.70129"},{"key":"e_1_3_5_15_2","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics. National vital statistics system mortality 2018-2023 on CDC WONDER online database [internet]. 2024. [cited 2025 July 1]. Available from: https:\/\/wonder.cdc.gov\/ucd-icd10-expanded.html"},{"key":"e_1_3_5_16_2","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics. National vital statistics system mortality 1999-2020 on CDC WONDER online database [internet]. 2021. [cited 2025 July 1]. Available from: https:\/\/wonder.cdc.gov\/ucd-icd10.html."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.02.044"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000041988"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2025.104063"},{"issue":"3","key":"e_1_3_5_20_2","first-page":"1","article-title":"Age standardization of death rates: implementation of the year 2000 standard","volume":"47","author":"Anderson RN","year":"1998","unstructured":"Anderson RN, Rosenberg HM. Age standardization of death rates: implementation of the year 2000 standard. Natl Vital Stat Rep. 1998;47(3):1-16.","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000000217"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-0258(20000215)19:3<335::aid-sim336>3.0.co;2-z"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3733"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-025-00713-9"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000041032"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-017-1668-x"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrad080"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000251364.32698.4b"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d7668"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.3389\/jaws.2023.11246"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-020-02269-5"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-023-02913-w"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.3633"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.55258"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000003992"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.09.039"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1590\/0100-6991e-20223324-en"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)31182-x"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251412265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251412265","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251412265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:19:31Z","timestamp":1777465171000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251412265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/00031348251412265"],"URL":"https:\/\/doi.org\/10.1177\/00031348251412265","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]}}}