Trends in mortality from chronic liver disease
Trends in mortality from chronic liver disease
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DOI：
10.1016/j.annepidem.2014.05.004
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发表时间：
2014-07-01
影响因子：
5.6
通讯作者：
Saugo, Mario
中科院分区：
文献类型：
--
作者：
Fedeli, Ugo;Avossa, Francesco;Saugo, Mario
目的：在过去的几十年里，大多数国家的肝硬化死亡率急剧下降，但仅包括一小部分因慢性肝病死亡的病例。方法：1995年至2010年期间，在韦内托地区（意大利东北部）提取了肝硬化、肝癌、病毒性肝炎和三种疾病合并的死亡率记录。通过拟合泊松回归模型评估出生队列效应的存在。结果：2008 - 2010年，肝硬化死亡率仅占全部肝病死亡的1/3，在病毒性死亡和老年人中，这一比例更小。在整个研究期间，肝硬化的年龄标准化率下降了50%，所有肝脏疾病的年龄标准化率下降了30%（世界标准）或25%（地区标准）;死亡率比例下降仅限于11%。在20世纪20年代早期以后出生的受试者中，死亡率开始下降。结论：死亡率的下降小于慢性肝病的标准统计数据;这些统计数据应常规包括病毒性肝炎和肝癌死亡。如有，应分析多种死因数据。(C)2014爱思唯尔公司All rights reserved.
Purpose: Mortality from liver cirrhosis has sharply declined in most countries in the last few decades, but includes only a fraction of deaths due to chronic liver disease.Methods: Mortality records for liver cirrhosis, liver cancer, viral hepatitis, and the three disease categories combined were extracted for the period 1995 to 2010 in the Veneto Region (northeastern Italy). The presence of a birth cohort effect was assessed by fitting Poisson regression models. The alcoholic or viral etiology was retrieved through multiple causes of death analysis for the years 2008 to 2010.Results: Liver cirrhosis mortality represented only one-third of all liver disease deaths; this proportion was even smaller for deaths with a viral etiology and among elderly people. Through the study period, age-standardized rates declined by 50% for liver cirrhosis, and by 30% (world standard) or by 25% (regional standard) for all liver diseases; the reduction in proportional mortality was limited to 11%. Mortality rates started to decline in subjects born after the early 1920s.Conclusions: The decline in mortality was smaller than that reported by standard statistics for chronic liver disease; these statistics should routinely include viral hepatitis and liver cancer deaths. When available, multiple causes of death data should be analyzed. (C) 2014 Elsevier Inc. All rights reserved.