Division of Gastroenterology and Hepatology, Chi Mei Medical Center, Tainan, Taiwan.
Department of Medicinal Chemistry, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Popul Health Metr. 2021 Apr 29;19(1):22. doi: 10.1186/s12963-021-00249-0.
The expanded definition of liver-related deaths includes a wide range of etiologies and sequelae. We compared the changes in liver-related mortality by etiology and sequelae for different age groups between 2008 and 2018 in the USA using both underlying and multiple cause of death (UCOD and MCOD) data.
We extracted mortality data from the CDC WONDER. Both the absolute (rate difference) and relative (rate ratio and 95% confidence intervals) changes were calculated to quantify the magnitude of change using the expanded definition of liver-related mortality.
Using the expanded definition including secondary liver cancer and according to UCOD data, we identified 68,037 liver-related deaths among people aged 20 years and above in 2008 (29 per 100,000) and this increased to 90,635 in 2018 (33 per 100,000), a 13% increase from 2008 to 2018. However, according to MCOD data, the number of deaths was 113,219 (48 per 100,000) in 2008 and increased to 161,312 (58 per 100,000) in 2018, indicating a 20% increase. The increase according to MCOD was mainly due to increase in alcoholic liver disease and secondary liver cancer (liver metastasis) for each age group and hepatitis C virus (HCV) and primary liver cancer among decedents aged 65-74 years.
The direction of mortality change (increasing or decreasing) was similar in UCOD and MCOD data in most etiologies and sequelae, except secondary liver cancer. However, the extent of change differed between UCOD and MCOD data.
肝相关死亡的扩展定义包括广泛的病因和后果。我们使用死因的根本原因和多种原因（UCOD 和 MCOD）数据，比较了 2008 年至 2018 年美国不同年龄组因病因和后果导致的肝相关死亡率的变化。
我们从疾病预防控制中心的 WONDER 中提取死亡率数据。使用扩展的肝相关死亡率定义，通过绝对（率差）和相对（率比和 95%置信区间）变化来量化变化的幅度。
使用包括继发性肝癌的扩展定义，根据 UCOD 数据，我们在 2008 年确定了 20 岁及以上人群中有 68037 例肝相关死亡（每 10 万人中有 29 例），这一数字在 2018 年增加到 90635 例（每 10 万人中有 33 例），比 2008 年增加了 13%。然而，根据 MCOD 数据，2008 年的死亡人数为 113219 例（每 10 万人中有 48 例），2018 年增加到 161312 例（每 10 万人中有 58 例），表明增加了 20%。MCOD 中增加的主要原因是每个年龄组的酒精性肝病和继发性肝癌（肝转移）以及 65-74 岁死者中的丙型肝炎病毒（HCV）和原发性肝癌的增加。
除了继发性肝癌，大多数病因和后果的 UCOD 和 MCOD 数据的死亡率变化方向（增加或减少）是相似的。然而，UCOD 和 MCOD 数据之间的变化程度有所不同。
