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Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study.
Scand J Gastroenterol. 2016 Aug; 51(8):961-6.SJ

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+Show Affiliations

a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;b School of Health Sciences, University of Tampere , Tampere , Finland.a Clinic of Gastroenterology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27181618

Citation

Sahlman, Perttu, et al. "Incidence, Survival and Cause-specific Mortality in Alcoholic Liver Disease: a Population-based Cohort Study." Scandinavian Journal of Gastroenterology, vol. 51, no. 8, 2016, pp. 961-6.
Sahlman P, Nissinen M, Pukkala E, et al. Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study. Scand J Gastroenterol. 2016;51(8):961-6.
Sahlman, P., Nissinen, M., Pukkala, E., & Färkkilä, M. (2016). Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study. Scandinavian Journal of Gastroenterology, 51(8), 961-6. https://doi.org/10.3109/00365521.2016.1157889
Sahlman P, et al. Incidence, Survival and Cause-specific Mortality in Alcoholic Liver Disease: a Population-based Cohort Study. Scand J Gastroenterol. 2016;51(8):961-6. PubMed PMID: 27181618.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study. AU - Sahlman,Perttu, AU - Nissinen,Markku, AU - Pukkala,Eero, AU - Färkkilä,Martti, Y1 - 2016/05/16/ PY - 2016/5/17/entrez PY - 2016/5/18/pubmed PY - 2017/4/25/medline KW - Alcoholic hepatitis KW - alcoholic liver disease KW - cause of death KW - liver cirrhosis KW - prognosis KW - survival SP - 961 EP - 6 JF - Scandinavian journal of gastroenterology JO - Scand J Gastroenterol VL - 51 IS - 8 N2 - 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. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/27181618/Incidence_survival_and_cause_specific_mortality_in_alcoholic_liver_disease:_a_population_based_cohort_study_ DB - PRIME DP - Unbound Medicine ER -