Alcoholic Liver Disease-Related Mortality in the United... : Official journal of the American College of Gastroenterology | ACG (original) (raw)
ORIGINAL CONTRIBUTIONS: LIVER
Paula, Helga MD1,3; Asrani, Sumeet K MD1,3; Boetticher, Nicholas C MD1; Pedersen, Rachel BA2; Shah, Vijay H MD1; Kim, Ray W MD1
1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
2Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
Correspondence: Vijay H. Shah, MD, Gastroenterology Research Unit, Guggenheim 10–21, Mayo Clinic Rochester, 200 First Street SW, Rochester, Minnesota 55905, USA. E-mail: [email protected]
3Co-first authors. These authors contributed equally to this work
published online 23 February 2010
Received 1 September 2009; accepted 29 January 2010
Abstract
OBJECTIVES:
Data on temporal changes in alcoholic liver disease (ALD)-related mortality in the United States are lacking. This longitudinal assessment is important, given the divergent data on trends in worldwide ALD-related mortality, concerns for underestimation of mortality attributed to ALD in previous investigations, and shifting attention to hepatitis C virus (HCV)-related mortality.
METHODS:
We analyzed mortality data compiled in the multiple cause-of-death public-use data file from the National Vital Statistics System from 1980 to 2003 using categorization by both International Classification of Diseases (ICD)-9 and ICD-10 systems. The main outcome measure was age- and sex-adjusted death rates attributable to ALD, HCV, or both (ALD/HCV) listed as immediate or underlying cause of death.
RESULTS:
A total of 287,365 deaths were observed over the 24-year period. Age- and sex- adjusted incidence rates of ALD-related deaths decreased from 6.9/100,000 persons in 1980 to 4.4/100,000 persons by 2003. After introduction of HCV diagnostic testing, HCV-related liver mortality increased to 2.9/100,000 persons by 2003. Death rates for subjects with concomitant ALD/HCV rose to 0.2/100,000 persons by 1999 and then remained unchanged through 2003. Age-specific mortality related to ALD was highest in the ages of 45–64 years. Between 1980 and 2003, the age- and sex-adjusted ALD-related mortality (per 100,000 persons) decreased from 6.3 to 4.5 among Caucasians, 11.6 to 4.1 among African Americans, and 8.0 to 3.7 among the “other” race group.
CONCLUSIONS:
Despite a decline in ALD-related mortality, the proportion of alcohol-related liver deaths is still considerably large and comparable in scope to that of HCV.
© The American College of Gastroenterology 2010. All Rights Reserved.