title: Recent heavy alcohol consumption at death certified as ischaemic heart disease: correcting mortality data from Kaunas (Lithuania).
abstract: OBJECTIVE
  To assess the proportion of deaths assigned to ischaemic heart disease (IHD) which in fact were caused by the toxic effects of alcohol, and how this may affect the official statistics of mortality from IHD in Lithuania.
  
  
  METHODS
  Using the IHD register in Kaunas, Lithuania, and verifying underlying causes of death using standard international methodology, 3061 cases were found in Kaunas city who had died from IHD at age 25-64 during 1993-2007. Out-of-hospital sudden deaths accounted for 2467 cases (81%), including 1498 where forensic autopsy was conducted and post-mortem concentration of alcohol in blood and urine was available.
  
  
  RESULTS
  In total, 78.4% of all initial IHD diagnoses were verified, while in 8.7% of deaths the underlying cause of death was corrected into an alcohol-related cause and in 12.9% to other diseases. Alcohol was found in about half (50.3%) of out-of-hospital death cases subjected to autopsy. In 18.0% of cases, the alcohol concentration was 3.5% or higher. Alcohol was more likely to be present in winter months and at weekends.
  
  
  CONCLUSIONS
  A significant number of alcohol-attributable deaths in Lithuania were misclassified as coronary deaths, accounting for almost one-tenth of officially registered deaths from IHD in ages 25-64. A high prevalence of positive post-mortem blood or urine alcohol tests suggests that the proportion of alcohol-related deaths among out-of-hospital IHD deaths may be actually even higher. A similar situation may be present in some other countries where high levels of alcohol consumption and binge drinking patterns are observed.
authors.affiliation: Department of Environmental and Occupational Medicine, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 4, LT- 50009 Kaunas, Lithuania. ricaradi@itc.kmu.lt
authors.forename: Ricardas
authors.initials: R
authors.lastname: Radisauskas
authors.forename: Remigijus
authors.initials: R
authors.lastname: Prochorskas
authors.forename: Vilius
authors.initials: V
authors.lastname: Grabauskas
authors.forename: Gailute
authors.initials: G
authors.lastname: Bernotiene
authors.forename: Abdonas
authors.initials: A
authors.lastname: Tamosiunas
authors.forename: Aurelijus
authors.initials: A
authors.lastname: Veryga
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000401:mortality / Q000639:trends; D001344:Autopsy; D002423:Cause of Death; D002492:Central Nervous System Depressants / Q000097:blood / Q000506:poisoning* / Q000652:urine; D016208:Databases, Factual; D003644:Death Certificates; D003645:Death, Sudden; D000431:Ethanol / Q000097:blood / Q000506:poisoning* / Q000652:urine; D005260:Female; D006760:Hospitalization; D006801:Humans; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000453:epidemiology* / Q000401:mortality
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol