Chronic liver disease mortality in the United States, 1990–1998

In 1998, chronic liver disease (CLD) was the tenth leading cause of death in the U.S. Alcohol and hepatitis C are thought to be important etiologies. However, traditional methods for calculating CLD mortality rates from death certificates may underestimate hepatitis C‐related CLD mortality. We studi...

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Veröffentlicht in:Hepatology (Baltimore, Md.) Jg. 39; H. 2; S. 476 - 483
Hauptverfasser: Vong, Sirenda, Bell, Beth P.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.02.2004
Wiley
Schlagworte:
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Chronic Disease
Death Certificates
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver Diseases - mortality
Male
Medical sciences
Middle Aged
United States - epidemiology
United States
North America
America
Chronic
Prognosis
Mortality
Gastroenterology
Digestive diseases
Hepatic disease
Epidemiology
ISSN:0270-9139, 1527-3350
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Zusammenfassung:In 1998, chronic liver disease (CLD) was the tenth leading cause of death in the U.S. Alcohol and hepatitis C are thought to be important etiologies. However, traditional methods for calculating CLD mortality rates from death certificates may underestimate hepatitis C‐related CLD mortality. We studied patterns of CLD deaths reported from 1990 through 1998, using an expanded definition that included death certificates where CLD, viral hepatitis, or CLD‐related sequelae were reported as the underlying cause. We calculated overall age‐specific and age‐adjusted mortality rates, and according to demographic characteristics and recorded causes, and evaluated trends using linear regression modeling. CLD mortality declined 5% overall from 1990 through 1994 (12.1 to 11.6/100,000; P = 0.002), but remained unchanged from 1995 through 1998 (P = 0.366). Decreases were similar for all causes except hepatitis C, for which rates increased 220% from 1993 to 1998 (0.57 to 1.67/100,000). Rates declined in all racial‐ethnic groups except American Indians and Alaska Natives (AI/AN), among whom rates were unchanged. Of 30,933 CLD deaths in 1998, 39% were coded as alcohol related, 15% as hepatitis C, 4% as hepatitis B, and 44% had no recorded cause. Age‐adjusted rates were higher among males (47.6/100,000) than females (32.2/100,000) and among Hispanics (19.1/100,000) compared with non‐Hispanics (10.8/100,000). Rates among AI/AN (28.7/100,000) were more than twice those of African Americans and whites (12.9/100,000 and 11.5/100,000, respectively). In conclusion, 1998 CLD deaths and the proportion attributable to viral hepatitis increased by 23% and 19%, respectively, compared with traditional methods. Mortality declines of the early 1990s were not sustained after 1994. Large disparities in CLD mortality remain, particularly among American Indians and Alaska Natives. (HEPATOLOGY 2004;39:476–483.)
Bibliographie:fax: 404‐371‐5221
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ISSN:0270-9139
1527-3350
DOI:10.1002/hep.20049