Mortality Rates in England, 1979–2005, with Particular Reference...

Mortality Rates in England, 1979–2005, with Particular Reference to Alcoholic Liver Disease
Sam J. Thomson1, Susan Westlake2, Tony M. Rahman1, Matthew L. Cowan1, Azeem Majeed3, J. Douglas Maxwell1 and Jin-Yong Kang1,*
1 Department of Gastroenterology and Hepatology, St George's Hospital, Blackshaw Rd, London, SW17 0QT, UK
2 Office for National Statistics, 1 Drummond Gate, London, SW1V 2QQ, UK
3 Department of Primary Care and Social Medicine, Charing Cross Campus, Imperial College, St Dunstan's Rd, London, W6 8RP, UK

* Author to whom correspondence should be addressed: Dr J.-Y. Kang, Department of Gastroenterology and Hepatology, St George's Hospital, Blackshaw Rd, London, England, SW17 0QT, UK. Tel.: 02 087253569; Fax: 02 087253520; E-mail: [email protected]

Received 15 January 2008; first review notified 29 January 2008; in revised form 13 February 2008; accepted 21 February 2008


Abstract


Aims: To determine time trends in hospital admissions for chronic liver disease in England between 1989/1990 and 2002/2003, mortality rates in England and Wales between 1979 and 2005, and the influence of alcohol-related disease on these trends. Methods: Hospital episode statistics for admissions in England were obtained from the Information Center for Health and Social Care and mortality data for England and Wales from the Office for National Statistics. Results: Hospital admission rates for chronic liver disease increased by 71% in males and 43% in females over the study period. This increase was largely due to alcoholic liver disease, admission rates for which more than doubled between 1989/1990 and 2002/2003. While there was a smaller rise for chronic viral hepatitis B and C, admission rates declined for hepatitis A, autoimmune hepatitis, and primary biliary cirrhosis. Mortality rates for chronic liver disease more than doubled between 1979 and 2005. Two thirds of these deaths were attributable to alcohol-related liver disease in 2005. The highest rate of alcoholic liver disease mortality was in the 45–64 age group, and the largest percentage increase between 1979 and 2005 occurred in the 25–34 age group. Conclusions: Hospital admissions and mortality in England from chronic liver disease are increasing. The underlying reasons are complex, but alcohol-induced liver disease makes a major contribution. There are clear social and health implications if the trend continues and addressing alcohol-related liver disease should be a public health priority.


http://alcalc.oxfordjournals.org/cgi/content/abstract/43/4/416





"Table 1

Etiologies of Hepatic Cirrhosis

Most common causes
Alcohol (60 to 70 percent)
Biliary obstruction (5 to 10 percent)
Biliary atresia/neonatal hepatitis
Congenital biliary cysts
Cystic fibrosis
Primary or secondary biliary cirrhosis
Chronic hepatitis B or C (10 percent)
Hemochromatosis (5 to 10 percent)
NAFLD (10 percent)-most commonly resulting from obesity; also can occur after jejunoileal bypass "
http://www.aafp.org/afp/20060901/756.html