title: Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study.
abstract: OBJECTIVE
  We studied the incidence of severe ALD requiring hospitalization in Finland, and survival and causes of death among the ALD patients.
  
  
  METHODS
  A cohort of 11,873 persons (8796 men and 3077 women) with diagnosis of ALD during the years 1996-2012 was identified from Finnish national Inpatient Register. The annual incidence of alcoholic hepatitis (AH) and alcoholic liver cirrhosis was calculated. The cohort was combined with the data from national Cause of Death Register of Statistics Finland.
  
  
  RESULTS
  The incidence of alcoholic liver cirrhosis increased from 8.8/100,000 in year 2001 to 14.6/100,000 in year 2012 among men and from 2.4 to 4.2/100,000 among women. The incidence of AH increased from 3.7 to 6.5/100,000 among men and from 1.3 to 2.7/100,000 among women. The relative 5-year survival ratios of patients with alcoholic liver cirrhosis and AH were 29 and 50% among men and 38 and 52% among women, respectively. Out of 8440 deaths, 65% were due to alcoholic-related causes. The risk of death among ALD patients was increased in malignancies (SMR 6.82; 95% CI: 6.35-7.29), cardiovascular diseases (6.13; 5.74-6.52), respiratory diseases (7.86; 6.70-9.10), dementia (3.31; 2.41-4.44) and accidents and violence (11.12; 10.13-12.15).
  
  
  CONCLUSIONS
  The incidence of AH and alcoholic liver cirrhosis is increasing. The survival is poor. Most deaths are alcohol-related and other common causes of excess deaths are cancers especially in the upper aerodigestive tract and cardiovascular, digestive and respiratory diseases as well as violence and accidents.
authors.affiliation: a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Perttu
authors.initials: P
authors.lastname: Sahlman
authors.affiliation: a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Markku
authors.initials: M
authors.lastname: Nissinen
authors.affiliation: b School of Health Sciences, University of Tampere , Tampere , Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.affiliation: a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Martti
authors.initials: M
authors.lastname: Färkkilä
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006519:Hepatitis, Alcoholic / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology / Q000401:mortality; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology* / Q000401:mortality; D008297:Male
keywords: Alcoholic hepatitis; alcoholic liver disease; cause of death; liver cirrhosis; prognosis; survival