Morbidity and mortality in liver diseases in Sweden 1969-2001 in relation to alcohol consumption

Objective. In Sweden, there is stable or slightly increased total alcohol consumption but a decrease in mortality in liver disease. The aim of the study was to determine the temporal relation between alcohol- related liver disease morbidity and mortality and type of alcohol beverage consumption. Material and methods. Data on patients with liver disease from the Swedish Hospital Discharge Register and from the Causes of Death Register between 1969 and 2001 were analysed. Data on the registered sales of the different beverages were taken from the Swedish State Monopoly. Results. Liver disease mortality increased from 1969 to 1976, coinciding with the increase in sales of spirits. Both mortality and spirits sales decreased thereafter, whereas there was no decrease in beer or wine sales. Hospitalization rates were reduced after 1987. Depending on age and gender, there was a 30 - 80% 5- year mortality rate following discharge. Among men, but not among women, differences in the alcohol and non- alcohol- related liver diagnoses in the Hospital Discharge Register and in the Cause of Death Register were sometimes recorded in the same patient. Conclusions. There was a reduction in hospitalization rates and mortality in liver diseases, and the reduction in mortality in liver diseases in Sweden from 1969 to 2001 seems to be associated with sales of spirits. Patients hospitalized for liver disease have a poor prognosis. There were difficulties in differentiating between alcohol and non- alcohol liver diseases.