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Cited by 311Liver Disease and TransplantationAlcohol Consumption and Health EffectsLiver Disease Diagnosis and Treatment

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Underestimation of liver‐related mortality in the United States

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Asrani, Sumeet K., Larson, Joseph J., Yawn, Barbara, Therneau, Terry M., Kim, W. Ray·2013·Gastroenterology
DOI 10.1053/j.gastro.2013.04.005PMC PMC3890240
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Abstract

Background & aims According to the National Center for Health Statistics (NCHS), chronic liver disease and cirrhosis is the 12(th) leading cause of death in the United States. However, this single descriptor might not adequately enumerate all deaths from liver disease. The aim of our study was to update data on liver mortality in the United States.Methods Mortality data were obtained from the Rochester Epidemiology Project (1999-2008) and the National Death Registry (1979-2008). Liver-specific mortality values were calculated. In contrast to the narrow NCHS definition, updated liver-related causes of death included other specific liver diagnoses (eg, hepatorenal syndrome), viral hepatitis, and hepatobiliary cancers.Results The Rochester Epidemiology Project database contained information on 261 liver-related deaths, with an age- and sex-adjusted death rate of 27.0/100,000 persons (95% confidence interval: 23.7-30.3). Of these, only 71 deaths (27.2%) would have been captured by the NCHS definition. Of cases for which viral hepatitis or hepatobiliary cancer was the cause of death, 96.9% and 94.3% had liver-related immediate causes of death, respectively. In analysis of data from the National Death registry (2008), use of the updated definition increased liver mortality by >2-fold (from 11.7 to 25.7 deaths/100,000, respectively). Using NCHS definitions, liver-related deaths decreased from 18.9/100,000 in 1979 to 11.7/100,000 in 2008-a reduction of 38%. However, using the updated estimate, liver-related deaths were essentially unchanged from 1979 (25.8/100,000) to 2008 (25.7/100,000). Mortality burden was systematically underestimated among non-whites and persons of Hispanic ethnicity.Conclusions Based on analyses of the Rochester Epidemiology Project and National Death databases, liver-related mortality has been underestimated during the past 2 decades in the United States.

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Metadata

Authors
Asrani, S. K., Larson, J. J., Yawn, B., Therneau, T. M., & Kim, W. R.
Affiliations
Mayo Clinic (US)
Corresponding author
Kim, W. Ray
ORCID
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2013-08
Volume
145
Issue
2
Pages
375-382.e2
ISSN
0016-5085 (ISSN-L)
DOI
10.1053/j.gastro.2013.04.005
PMC
PMC3890240
OpenAlex
W2079748214
Cited by
311
References
45
Citations by year
2026: 9 · 2025: 10 · 2024: 17 · 2023: 30 · 2022: 25 · 2021: 29 · 2020: 27 · 2019: 23 · 2018: 34 · 2017: 28 · 2016: 23 · 2015: 24 · 2014: 23 · 2013: 8
FWCI
16.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (K24DK-92336, R01DK-34238, T32 DK07198)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Keywords
liver-related mortality, chronic liver disease, liver cirrhosis, mortality underestimation, cause of death classification, viral hepatitis, hepatobiliary cancer, hepatorenal syndrome, racial and ethnic disparities, Rochester Epidemiology Project
MeSH terms
Adult, Aged, Cause of Death, Female, Hepatic Encephalopathy, Hepatitis, Viral, Human, Carcinoma, Hepatocellular, Hepatorenal Syndrome, Humans, Liver Cirrhosis, Liver Diseases, Liver Neoplasms, Male, Middle Aged, Minnesota, National Center for Health Statistics, U.S., United States

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