Alcoholic Liver Disease-Related Mortality in the United States: 1980–2003

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.

HBV infection is associated with greater mortality in hospitalised patients compared to HCV infection or alcoholic liver disease

“…4 Similarly, deaths related to alcoholic liver disease (ALD) have been decreasing from 6.9 per 100 000 in 1980 to 4.4 per 100 000 in 2003. 5 In contrast, mortality from hepatitis C (HCV) has been rising from 3.0 per 100 000 in 1999 to 4.5 per 100 000 in 2007 likely as the baby-boomer generation experiences the complications of long-standing HCV infection. 4 Hospitalisation for liver disease is associated with significant rates of adverse outcomes and hospitalised patients form a particularly important cohort for study.…”

Influence of Serum Sodium on MELD-Based Survival Prediction in Alcoholic Hepatitis

“…1 Alcoholic liver disease (ALD) encompasses a broad spectrum of conditions, including fatty liver, alcoholic hepatitis (AH), and cirrhosis. Fatty liver is reversible with alcohol cessation, but patients with AH and cirrhosis have a potentially more severe prognosis.…”

Bacterial translocation and changes in the intestinal microbiome associated with alcoholic liver disease

“…Half of all cirrhotic patients die within 2 years of diagnosis. Mortality fro� alcoholic liver disease (ALD) has been declining in recent years, likely due to i��rove�ents in clinical �anage�ent of co��lications of ALD including �ortal hy�ertension and bleeding fro� eso�hageal varices [4] . A significant percentage of cirrhotic patients succumb to bacterial infections with infectionattributed �ortality of 30% to 50% [5�7�] .…”