Kraglund Frederik, Deleuran Thomas, Askgaard Gro, Fleming Kate M, Jepsen Peter
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Medicine, Randers Regional Hospital, Randers, Denmark.
Clin Epidemiol. 2021 Jan 7;13:1-11. doi: 10.2147/CLEP.S287870. eCollection 2021.
Alcohol consumption has decreased in Denmark in recent years. We aimed to illustrate and investigate the developments in the incidence, hospital care, and mortality of alcohol-related liver disease (ALD) in Denmark during the last 25 years.
Through nationwide healthcare registries, we identified all Danish patients with incident ALD in 1994-2018. We computed standardized incidence rates by sex, age, and geography, age-specific incidence rates by birth cohort, and standardized prevalence. We enumerated inpatient admissions, days of admission, outpatient visits, and emergency room visits. Lastly, we estimated relative risks of mortality, standardized mortality rates, and the proportion of deaths caused by ALD.
The standardized incidence rate decreased from its peak at 357 per 1,000,000 in 2009 to 240 per 1,000,000 in 2018, and the decrease was evident for both sexes and all age groups below 70 years. The standardized prevalence was stable around 0.22% from 2011 onwards. There was an almost fivefold geographic variation in standardized incidence by municipalities, and age-specific incidence rates decreased sequentially with each 5-year birth cohort after 1960. The number of inpatient admissions, days of admission, and emergency room visits decreased during the study period, while the number of outpatient visits was stable. For patients diagnosed in 2014-2018 compared to 1994-1998, the relative risk of 1-year mortality was 0.83 (95% confidence interval: 0.78-0.87), and the standardized mortality along with the proportion of deaths caused by ALD decreased during the study period.
The incidence of ALD decreased from 357 to 240 per 1,000,000 over the last 10 years in Denmark. During the same period, the prevalence remained stable around 0.22% and mortality decreased. Additionally, the burden of ALD on hospital care decreased significantly between 1994 and 2018. We anticipate a further decrease in the incidence of ALD in the future.
近年来丹麦的酒精消费量有所下降。我们旨在阐述并研究丹麦过去25年中酒精性肝病（ALD）的发病率、住院治疗情况及死亡率的发展趋势。
通过全国医疗保健登记系统，我们确定了1994 - 2018年期间所有丹麦ALD确诊患者。我们计算了按性别、年龄和地理位置划分的标准化发病率、按出生队列划分的年龄别发病率以及标准化患病率。我们统计了住院人数、住院天数、门诊就诊次数和急诊就诊次数。最后，我们估计了死亡率的相对风险、标准化死亡率以及ALD导致的死亡比例。
标准化发病率从2009年每100万人中的峰值357降至2018年的每100万人240，且在70岁以下的所有性别和年龄组中下降均明显。自2011年起，标准化患病率稳定在0.22%左右。各市镇的标准化发病率存在近五倍的地理差异，1960年后每5年出生队列的年龄别发病率依次下降。在研究期间，住院人数、住院天数和急诊就诊次数减少，而门诊就诊次数稳定。与1994 - 1998年诊断的患者相比，2014 - 2018年诊断患者的1年死亡率相对风险为0.83（95%置信区间：0.78 - 0.87），在研究期间标准化死亡率以及ALD导致的死亡比例均下降。
在过去10年中，丹麦ALD的发病率从每100万人357降至240。同期，患病率稳定在0.22%左右且死亡率下降。此外，1994年至2018年期间，ALD对医院护理的负担显著减轻。我们预计未来ALD的发病率将进一步下降。
