Multivariate adjusted trends in adult alcoholic liver disease mortality in the United States, 1999–2017
Am J Transl Res. 2022 Feb 15;14(2):1092-1099. eCollection 2022.
OBJECTIVE: Trends in alcoholic liver disease (ALD) mortality have recently increased and differ according to various factors in the United States. However, these trends have only been analyzed using univariate models and, in fact, they can be influenced by various factors. We therefore examined trends in age-standardized mortality from ALD among US adults for the period 1999-2017, using piecewise multivariate log-linear models.
METHODS: We collected mortality data from the Centers for Disease Control and Prevention’s Large Scale Epidemiological Research Online Database, using the underlying cause of death.
RESULTS: We identified 296,194 ALD deaths and 346,386 deaths indirectly attributable to ALD during the period 1999-2017. ALD mortality adjusted for several variables and standardized according to age was stable between 1999 and 2006 (annual variation in percentage [APC]=-2.24, P=0.24), and increased between 2006 and 2017 (APC=3.18, Pfatty liver disease (APC=4.64, Pliver cancer (APC=-2 .82, P
CONCLUSIONS: ALD exhibited an increasing trend in multivariate-adjusted, age-standardized mortality among US adults, with no significant differences by gender, race, age, or urbanization. Three ALD subtypes (alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis) and non-alcoholic cirrhosis had increasing mortality trends, while other ALD subtypes and other causes of death did not.