Abstract
BackgroundThe analysis of multiple causes of death data has been applied in the United States to examine the population burden of chronic liver disease (CLD) and to assess time trends of alcohol-related and hepatitis C virus (HCV)-related CLD mortality. The aim of this study was to assess the mortality for CLD by etiology in the Veneto Region (northeastern Italy).MethodsUsing the 2008–2010 regional archive of mortality, all causes registered on death certificates were extracted and different descriptive epidemiological measures were computed for HCV-related, alcohol-related, and overall CLD-related mortality.ResultsThe crude mortality rate of all CLD was close to 40 per 100,000 residents. In middle ages (35 to 74 years) CLD was mentioned in about 10% and 6% of all deaths in males and females, respectively. Etiology was unspecified in about half of CLD deaths. In females and males, respectively, HCV was mentioned in 44% and 21% and alcohol in 11% and 26% of overall CLD deaths. A bimodal distribution with age was observed for HCV-related proportional mortality among females, reflecting the available seroprevalence data.ConclusionsMultiple causes of death analyses can provide useful insights into the burden of CLD mortality according to etiology among different population subgroups.
Highlights
The analysis of multiple causes of death data has been applied in the United States to examine the population burden of chronic liver disease (CLD) and to assess time trends of alcohol-related and hepatitis C virus (HCV)-related CLD mortality
Mortality from liver cirrhosis has been declining in southern Europe over the last decades, possibly due to a reduction in alcoholic liver disease prevalence, a fall in the transmission of hepatitis C virus (HCV) infection, and vaccination campaigns against hepatitis B virus (HBV) [1,2]
Mortality statistics are limited to the underlying cause of death, but a useful approach is represented by the analysis of all diseases reported on death certificates, because it permits more extensive capture of chronic liver disease (CLD)-related deaths
Summary
The analysis of multiple causes of death data has been applied in the United States to examine the population burden of chronic liver disease (CLD) and to assess time trends of alcohol-related and hepatitis C virus (HCV)-related CLD mortality. When liver cirrhosis is mentioned on the death certificate, a related disease (e.g., liver cancer or viral hepatitis) or another disease category could be selected as the underlying cause Such analysis allows the retrieval of the etiology of CLD. Suffering from the underreporting of causes and types of liver diseases, the analysis of multiple causes of death data has been applied in US studies to examine time trends in HCV- and alcohol-related CLD mortality [4-7] and to assess the burden of CLD in high-risk subpopulations [8-10]
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