Prevalence of alcohol related pathologies at autopsy: Estonian Forensic Study of Alcohol and Premature Death.


Tuusov, J; Lang, K; Väli, M; Pärna, K; Tõnisson, M; Ringmets, I; McKee, M; Helander, A; Leon, DA; (2014) Prevalence of alcohol related pathologies at autopsy: Estonian Forensic Study of Alcohol and Premature Death. Addiction (Abingdon, England). ISSN 0965-2140 DOI: https://doi.org/10.1111/add.12695

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Abstract

AIMS: Alcohol can induce diverse serious pathologies yet this complexity may be obscured when alcohol-related deaths are classified according to a single underlying cause. We sought to quantify this issue and its implications for analysing mortality data.<br/> DESIGN, SETTINGS AND PARTICIPANTS: Cross-sectional study included 554 men aged 25-54 in Estonia undergoing forensic autopsy in 2008-9.<br/> MEASUREMENTS: Potentially alcohol-related pathologies were identified following macroscopic and histological examination. Alcohol biomarkers levels were determined. For a subset (∼30%), drinking behaviour was provided by next-of-kin. The Estonian Statistics Office provided underlying cause of death.<br/> FINDINGS: Most deaths (∼75%) showed evidence of potentially alcohol-related pathologies, and 32% had pathologies in two or more organs. The liver was most commonly affected (61%, 95% CI 56-65) followed by the lungs (19%, 95% CI 15-22), stomach (18%, 95% CI 14-21), pancreas (14%, 95% CI 11-17), heart (5%, 95% CI 3-7) and oesophagus (1%, 95% CI 1-3). Only a minority with liver pathology had a second pathology. The number of pathologies correlated with alcohol biomarkers (phosphatidylethanol, gamma-glytamyl transpeptidase in blood, ethylglucuronide, ethylsulfate in urine). Despite the high prevalence of liver pathology few deaths had alcoholic liver disease specified as the underlying cause.<br/> CONCLUSION: The majority of 554 men aged 25-54 undergoing forensic autopsy in Estonia in 2008-9 showed evidence of alcohol-related pathology. However, the recording of deaths by underlying cause failed to capture the scale and nature of alcohol-induced pathologies found.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: ECOHOST - The Centre for Health and Social Change
PubMed ID: 25066373
Web of Science ID: 344780300014
URI: http://researchonline.lshtm.ac.uk/id/eprint/1848572

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