Study shows alarming trends in alcoholic cirrhosis mortality in the United States

Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States, between 2010 and 2016, alcohol-related liver disease was the leading cause of nearly one in three liver transplants, surpassing hepatitis C.

Researchers at Florida Atlantic University’s Schmidt College of Medicine conducted an original research study using the U.S. Centers for Disease Control and Prevention’s Expanded Online Data for Epidemiological Research (WONDER) to compare trends in alcoholic cirrhosis mortality in the United States in 1999 with those 20 years later in 2019. They calculated mortality rates and mortality rate ratios (MRRs) per 100,000 of alcoholic cirrhosis in groups of age of 10 years from 25 to 85 years and older as measures of effect and 95% confidence intervals to test significance.

The results of the study, published online ahead of print in The American Journal of Medicine, showed that in 1999 there were 6,007 deaths from alcoholic cirrhosis among 180,408,769 Americans aged 25 to 85 and older, giving a mortality rate of 3.3 per 100,000. In 2019, there were 23,780 deaths from alcoholic cirrhosis among 224,981,167 Americans ages 25 to 85 and older, giving a death rate of 10.6 per 100,000.

“It is very disturbing that in the United States, between 1999 and 2019, we have seen more than three times as many deaths from alcoholic cirrhosis,” said Lawrence Fiedler, MD, co-author, board-certified practicing gastroenterologist. and affiliate. associate professor at FAU Schmidt College of Medicine. “The damage caused by chronic and excessive alcohol consumption leads to fatty liver and alcoholic hepatitis. Over time, this leads to scarring and cirrhosis, the final, irreversible phase of alcoholic liver disease.”

In the United States, between 1999 and 2019, there were also statistically significant increases in mortality from alcoholic cirrhosis in every 10-year age group from 25 to 85 and older. It should also be noted that the largest increase was sevenfold in the 24-35 age group and the largest increase was seen in the 65-74 age group.

Although more research is needed, these alarming trends in mortality from alcoholic cirrhosis pose immediate clinical and public health challenges to curbing the epidemics of heavy alcohol consumption as well as overweight, obesity and lack of nutrition. physical activity in the United States, all of which can contribute. .”

Charles H. Hennekens, MD, Dr.PH, Corresponding Author, First Sir Richard Doll Professor of Medicine and Senior Academic Advisor, FAU Schmidt College of Medicine

The researchers note that primary care providers may want to advise all of their patients that people who drink large amounts of alcohol have the highest mortality rates for both cirrhosis and cardiovascular disease. Although the data indicates that those who choose one to two drinks a day have a lower risk of cardiovascular disease than non-drinkers, it is also true that the difference between drinking small and larger amounts of alcohol means the difference between preventing and causing premature death.

“Specifically, rates of myocardial infarction and stroke as well as hypertension, hemorrhagic stroke, and breast cancer are all beginning to exceed one drink a day, particularly among women,” Hennekens said. “Furthermore, the impacts of increased alcohol consumption at an earlier age as well as overweight, obesity, and lack of physical activity may all contribute, singly or in combination, to the observed increases in mortality due to alcoholic cirrhosis.”