An epidemic of deaths attributed to fatty liver in Baltimore

Abstract

Death rates due to cirrhosis of the liver have increased substantially in the past 20 years. Previous studies have noted that sudden deaths in which a fatty liver was the major pathological finding accounted for a large part of the increase in death rates. The current study of sudden nontraumatic deaths in Baltimore noted that 40% of the “cirrhosis” deaths were sudden. Fatty liver sudden deaths accounted for 25% of the total nontraumatic sudden deaths. Cirrhosis and fatty liver death rates were much higher in men than women and in blacks as compared to whites. Most fatty liver sudden deaths were unwitnessed. The majority of those dying did not have high blood alcohol levels. At postmortem examination, the liver was usually enlarged. Microscopic examination revealed extensive fatty change often with increased eosinophilia of hepatocytes and the presence of Mallory bodies in about 20%. In about half of the fatty liver sudden deaths there was also some degree of periportal fibrosis.