1 Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, NM, USA.
Public Health Rep. 2018 May/Jun;133(3):287-293. doi: 10.1177/0033354918766890. Epub 2018 Apr 17.
Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths.
We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non-alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity.
By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4).
An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.
当前的慢性肝病（CLD）死亡率监测方法可能无法充分捕捉所有 CLD 死亡原因的数据。本研究的目的是通过使用更广泛的 CLD 定义和估计酒精对 CLD 死亡的分数影响，来计算和比较新墨西哥州和美国的 CLD 死亡率。
我们将 CLD 死亡率定义为因酒精性肝病、肝硬化、病毒性肝炎和其他肝脏疾病导致的死亡。我们使用疾病控制与预防中心的酒精相关疾病影响应用程序中的国家和州酒精归因分数来估计酒精归因性 CLD 死亡。我们将 CLD 死亡的原因分类为归因于酒精、非归因于酒精或丙型肝炎。我们计算了 1999 年至 2013 年五个 3 年期间的平均年度年龄调整 CLD 死亡率，并按性别、年龄和种族/族裔对这些死亡率进行分层。
按死因分类，酒精归因性 CLD 的死亡率最高。按性别和种族/族裔划分，新墨西哥州的美国印第安男性（67.4-90.6）和美国（38.9-49.4）、新墨西哥州的美国印第安女性（48.4-63.0）和美国（27.5-39.5）、新墨西哥州的西班牙裔男性（48.6-52.0）和美国（48.6-52.0）、新墨西哥州的西班牙裔女性（16.9-24.0）和美国（12.8-13.1）、新墨西哥州的非西班牙裔白种男性（17.4-21.3）和美国（15.9-18.4）以及新墨西哥州的非西班牙裔白种女性（9.7-11.6）和美国（7.6-9.7）的 CLD 死亡率均有所上升。美国的西班牙裔男性 CLD 死亡率有所下降（30.5-27.4）。
使用更广泛的 CLD 定义和酒精归因分数可以创建关于 CLD 死亡率的综合数据。按 CLD 病因和人口统计学特征分层后，这些数据可能有助于各州和司法管辖区改善 CLD 预防计划。
