Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Jun;83(6):838–844. doi: 10.2105/ajph.83.6.838

The prevalence of alcohol-related mortality in both sexes: variation between indicators, Stockholm, 1987.

A Romelsjö 1, G Karlsson 1, L Henningsohn 1, S W Jakobsson 1
PMCID: PMC1694754  PMID: 8498621

Abstract

OBJECTIVES. The purpose of this study was to analyze the prevalence rates of alcohol-related mortality--according to various indicators--in both sexes in Stockholm, Sweden. METHODS. A study of alcohol involvement at death was undertaken for all 668 deceased persons aged 15 through 54 years in 1987 in Stockholm. Death certificates, autopsy information, police records, and information about earlier conviction were analyzed. RESULTS. When different measures of estimation were compared, there were great differences in the prevalence rates of alcohol involvement. According to the death certificates, 9.2% of the males and 11.2% of the females had alcoholism, alcohol intoxication, pancreatitis or liver cirrhosis as underlying cause of death. When all accessible information was used, potential alcohol involvement was found in 57.5% of the male and in 32.2% of the female deaths. There was a marked association between earlier drunken driving and alcohol involvement. After reevaluation of the diagnoses with autopsy findings, the number of cases with cardiac enlargement and suspected cardiomyopathy increased from 10 to 62. CONCLUSION. The results point to the serious underdiagnosis of alcohol involvement in death certificates and the misclassification of important causes of death (i.e., liver cirrhosis and cardiac disease); they also call for increased efforts regarding prevention.

Full text

PDF
838

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agren G., Jakobsson S. W. Validation of diagnoses on death certificates for male alcoholics in Stockholm. Forensic Sci Int. 1987 Apr;33(4):231–241. doi: 10.1016/0379-0738(87)90104-6. [DOI] [PubMed] [Google Scholar]
  2. Bell G., Cremona A. Alcohol and death certification: influencing current practice and attitudes. Br J Addict. 1989 Dec;84(12):1523–1525. doi: 10.1111/j.1360-0443.1989.tb03935.x. [DOI] [PubMed] [Google Scholar]
  3. Blake J. E., Compton K. V., Schmidt W., Orrego H. Accuracy of death certificates in the diagnosis of alcoholic liver cirrhosis. Alcohol Clin Exp Res. 1988 Feb;12(1):168–172. doi: 10.1111/j.1530-0277.1988.tb00154.x. [DOI] [PubMed] [Google Scholar]
  4. Britton M. Diagnostic errors discovered at autopsy. Acta Med Scand. 1974 Sep;196(3):203–210. doi: 10.1111/j.0954-6820.1974.tb00996.x. [DOI] [PubMed] [Google Scholar]
  5. Charness M. E., Simon R. P., Greenberg D. A. Ethanol and the nervous system. N Engl J Med. 1989 Aug 17;321(7):442–454. doi: 10.1056/NEJM198908173210706. [DOI] [PubMed] [Google Scholar]
  6. Fleming K. A., McGee J. O. Alcohol induced liver disease. J Clin Pathol. 1984 Jul;37(7):721–733. doi: 10.1136/jcp.37.7.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gittelsohn A., Senning J. Studies on the reliability of vital and health records: I. Comparison of cause of death and hospital record diagnoses. Am J Public Health. 1979 Jul;69(7):680–689. doi: 10.2105/ajph.69.7.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. HAELLEN J., NORDEN J. LIVER CIRRHOSIS UNSUSPECTED DURING LIFE. A SERIES OF 79 CASES. J Chronic Dis. 1964 Oct;17:951–958. doi: 10.1016/0021-9681(64)90164-x. [DOI] [PubMed] [Google Scholar]
  9. Kreitman N. Alcohol consumption and the preventive paradox. Br J Addict. 1986 Jun;81(3):353–363. doi: 10.1111/j.1360-0443.1986.tb00342.x. [DOI] [PubMed] [Google Scholar]
  10. Maxwell J. D., Knapman P. Effect of coroners' rules on death certification for alcoholic liver disease. Br Med J (Clin Res Ed) 1985 Sep 14;291(6497):708–708. doi: 10.1136/bmj.291.6497.708. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Morgan M. Y., Sherlock S. Sex-related differences among 100 patients with alcoholic liver disease. Br Med J. 1977 Apr 9;1(6066):939–941. doi: 10.1136/bmj.1.6066.939. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Moriyama I. M. Problems in measurement of accuracy of cause-of-death statistics. Am J Public Health. 1989 Oct;79(10):1349–1350. doi: 10.2105/ajph.79.10.1349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Petersson B., Krantz P., Kristensson H., Trell E., Sternby N. H. Alcohol-related death: a major contributor to mortality in urban middle-aged men. Lancet. 1982 Nov 13;2(8307):1088–1090. doi: 10.1016/s0140-6736(82)90015-0. [DOI] [PubMed] [Google Scholar]
  14. Pollock D. A., Boyle C. A., DeStefano F., Moyer L. A., Kirk M. L. Underreporting of alcohol-related mortality on death certificates of young US Army veterans. JAMA. 1987 Jul 17;258(3):345–348. [PubMed] [Google Scholar]
  15. Rajs J., Jakobsson S. W. Cause of death in persons aged between 15 and 50 years in the community of Stockholm. A forensic-pathologic and statistical study. Forensic Sci Int. 1985 Nov-Dec;29(3-4):213–226. doi: 10.1016/0379-0738(85)90115-x. [DOI] [PubMed] [Google Scholar]
  16. Regan T. J. Alcohol and the cardiovascular system. JAMA. 1990 Jul 18;264(3):377–381. [PubMed] [Google Scholar]
  17. Riddick L., Luke J. L. Alcohol-associated deaths in the District of Columbia--a postmortem study. J Forensic Sci. 1978 Jul;23(3):493–502. [PubMed] [Google Scholar]
  18. Rimm E. B., Giovannucci E. L., Willett W. C., Colditz G. A., Ascherio A., Rosner B., Stampfer M. J. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991 Aug 24;338(8765):464–468. doi: 10.1016/0140-6736(91)90542-w. [DOI] [PubMed] [Google Scholar]
  19. Rubin E., Lieber C. S. Alcohol-induced hepatic injury in nonalcoholic volunteers. N Engl J Med. 1968 Apr 18;278(16):869–876. doi: 10.1056/NEJM196804182781602. [DOI] [PubMed] [Google Scholar]
  20. Saracci R. Is necropsy a valid monitor of clinical diagnosis performance? BMJ. 1991 Oct 12;303(6807):898–900. doi: 10.1136/bmj.303.6807.898. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Seligson U., Cho J. W., Ihre T., Lundh G. Clinical course and autopsy findings in acute and chronic pancreatitis. Acta Chir Scand. 1982;148(3):269–274. [PubMed] [Google Scholar]
  22. Shaper A. G. Alcohol and mortality: a review of prospective studies. Br J Addict. 1990 Jul;85(7):837–861. doi: 10.1111/j.1360-0443.1990.tb03710.x. [DOI] [PubMed] [Google Scholar]
  23. Susser M. What is a cause and how do we know one? A grammar for pragmatic epidemiology. Am J Epidemiol. 1991 Apr 1;133(7):635–648. doi: 10.1093/oxfordjournals.aje.a115939. [DOI] [PubMed] [Google Scholar]
  24. Svendsen H. O., Mosbech J. Alcoholic cirrhosis of the liver in the Scandinavian countries 1961-1974. Int J Epidemiol. 1977 Dec;6(4):345–348. doi: 10.1093/ije/6.4.345. [DOI] [PubMed] [Google Scholar]
  25. Särkioja T., Hirvonen J. Causes of sudden unexpected deaths in young and middle-aged persons. Forensic Sci Int. 1984 Apr;24(4):247–261. doi: 10.1016/0379-0738(84)90159-2. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES