Ali Hassam, Jahagirdar Vinay, Blaney Hanna, Dahiya Dushyant Singh, Gangwani Manesh K, Patel Pratik, Hayat Umar, Jaber Fouad, Simonetto Douglas A, Satapathy Sanjaya K
Department of Gastroenterology, Hepatology & Nutrition ECU Health Medical Center/Brody School of Medicine Greenville North Carolina USA.
Department of Internal Medicine University of Missouri-Kansas City School of Medicine Kansas City Missouri USA.
JGH Open. 2024 Dec 3;8(12):e70057. doi: 10.1002/jgh3.70057. eCollection 2024 Dec.
Alcohol-related liver disease (ALD) has emerged as a significant public health concern, particularly among younger populations. ALD remains the leading cause of alcohol-attributable deaths. This study aims to forecast ALD mortality trends up to 2030, focusing on individuals under 55 years.
We utilized data from the CDC WONDER database (1999-2022) to examine ALD-related deaths, identified by ICD-10 codes (K70.0-K70.9). Crude mortality rates (CMRs) per 100 000 were analyzed and temporal trends were assessed using annual and average annual percent changes (APC/AAPC) with empirical quantile confidence intervals. An Autoregressive Integrated Moving Average (ARIMA) model was employed to project mortality rates until 2030, validated through time series cross-validation.
From 1999 to 2022, there were 181 862 ALD-related deaths among individuals under 55, with mortality rates increasing from 3.9 per 100 000 in 1999 to 9.7 per 100 000 in 2022 (AAPC 4.66%, 95% CI: 3.90%-5.86%). Projections suggest rates will continue to rise, reaching 14.4 per 100 000 by 2030. From 1999 to 2022, the 25-34 age group experienced the highest increase, with an AAPC of 10.27% (95% CI: 9.19%-11.35%), while the 35-44 and 45-54 age groups showed more moderate increases, with AAPCs of 5.03% and 4.38%, respectively. Projections indicate an AAPC of 3.86% for ages 25-34, 3.90% for ages 35-44, and 6.17% for ages 45-54 by 2030.
Forecasts indicate a continued rise in ALD mortality among individuals under 55, necessitating immediate public health strategies to mitigate this trend.
酒精性肝病（ALD）已成为一个重大的公共卫生问题，尤其是在年轻人群体中。ALD仍然是酒精所致死亡的主要原因。本研究旨在预测到2030年ALD的死亡率趋势，重点关注55岁以下人群。
我们利用美国疾病控制与预防中心（CDC）的WONDER数据库（1999 - 2022年）中的数据，通过国际疾病分类第十版（ICD - 10）编码（K70.0 - K70.9）来检查与ALD相关的死亡情况。分析了每10万人的粗死亡率（CMRs），并使用年度和平均年度百分比变化（APC/AAPC）以及经验分位数置信区间评估时间趋势。采用自回归积分滑动平均（ARIMA）模型预测到2030年的死亡率，并通过时间序列交叉验证进行验证。
1999年至2022年期间，55岁以下人群中有181862例与ALD相关的死亡，死亡率从1999年的每10万人3.9例增至2022年的每10万人9.7例（平均年度百分比变化为4.66%，95%置信区间：3.90% - 5.86%）。预测表明死亡率将继续上升，到2030年将达到每10万人14.4例。1999年至2022年期间，25 - 34岁年龄组的增长幅度最大，平均年度百分比变化为10.27%（95%置信区间：9.19% - 11.35%），而35 - 44岁和45 - 54岁年龄组的增长较为平缓，平均年度百分比变化分别为5.03%和4.38%。预测显示，到2030年，25 - 34岁年龄组的平均年度百分比变化为3.86%，35 - 44岁年龄组为3.90%，45 - 54岁年龄组为6.17%。
预测表明55岁以下人群中ALD死亡率将持续上升，因此需要立即采取公共卫生策略来缓解这一趋势。
