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Monday, November 18, 2019
Home Specialties Gastroenterology Deaths from Liver Disease Surge: Who’s at Risk, Steps to Intervene

Deaths from Liver Disease Surge: Who’s at Risk, Steps to Intervene

Deaths from alcoholic cirrhosis have skyrocketed in the US, according to a study published in the British Medical Journal — particularly among white, native, and Hispanic Americans ages 25-34.

In an observational cohort study, Tapper and Parikh[1] reviewed death certificate data and also population from the US Census Bureau to look at trends in deaths related to liver disease by age, sex, race, cause of liver disease, and geographic region. The study period was from 1999 to 2016.

Among the key findings:

  • Annual deaths from cirrhosis rose by 65% from 1999 to 2016 (to 34,174).
  • During that period, annual deaths from hepatocellular carcinoma doubled (to 11,073).
  • Deaths from peritonitis and sepsis in those with cirrhosis rose substantially during the study period: respective annual increases were 6.1% and 7.1%.
  • The fastest rise in liver disease-related diseases occurred in western and southwestern states, as this graph shows.
  • Deaths from hepatocellular carcinoma dropped only among Asians and Pacific Islanders (a 2.7% decrease in the death rate)

What factors may have fueled this surge in liver disease deaths? The study doesn’t speculate, but in an interview with The New York Times, lead author, Dr. Elliot Tapper suggests that economic turmoil could be a factor. He comments that “people started dying at increased rates after 2008,” the year that the Great Recession began.

The rise in deaths from cirrhosis-related deaths is, perhaps, not surprising. In its new practice guideline on the treatment of alcohol use disorder The American Psychiatric Association (APA) reports an estimated lifetime prevalence rate of 29% for alcohol use disorder. Yet only about 1 in 10 people with this diagnosis gets any help.

Given that nearly one in 3 Americans may have an alcohol abuse problem, what can you do to help? The APA’s guideline offers tips on assessment, specifics on evidence-based pharmacologic treatment (eg, naltrexone and acomprosate as first-line agents for those with moderate to severe alcohol use disorder), and evidence-based psychotherapeutic therapies.

Last updated on 9/7/19.

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