Alcoholic liver disease-related mortality in the United States: 1980-2003.
OBJECTIVE
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.
Paula
Helga
H
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Asrani
Sumeet K
SK
Boetticher
Nicholas C
NC
Pedersen
Rachel
R
Shah
Vijay H
VH
Kim
W Ray
WR
D000368:Aged; D002423:Cause of Death; D005260:Female; D006526:Hepatitis C / Q000208:ethnology / Q000401:mortality; D006801:Humans; D038801:International Classification of Diseases; D008108:Liver Diseases, Alcoholic / Q000208:ethnology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014798:Vital Statistics