The Direct and Contributory Role of Alcohol to Mortality Rates
Cliona M Ryan, Stephen F Crowther. Tallaght Hospital, Dublin, Ireland
Background: Excess alcohol consumption is an ever-increasing public health concern in modern society. A key area in which the health implications of alcohol can be assessed are in mortality rates, and in particular its contribution to suicide. It has been estimated by the World Health Organisation that harmful use of alcohol accounts for 3.8% of deaths annually worldwide. In this study we aim to examine the role played by alcohol in all coronial deaths in a single autopsy centre in a suburban area of West Dublin, with a catchment area of almost one quarter of a million people.
Design: This case series includes all non-forensic coronial adult autopsies performed in our institution over a 12-month period. It involved a review of all post-mortem reports with collation of data including patient demographics, location of death, toxicology results and cause of death including significant contributing factors.
Results: 226 autopsies were carried out (61% male; 39% female). The age of the deceased ranged from 16 to 96 years, with an average age of 61 years. 22.1% of deaths occurred in the emergency department, 22.1% in hospital, 6.1% in a community care facility and 48.7% out of hospital. Toxicology was carried out in 61% of cases. Of these, alcohol was detected in 38.4% of cases (23.4% of all autopsies). Alcohol toxicity was the primary cause of death in 1.8% of all autopsies (n=4) with death from a chronic condition directly related to alcohol abuse accounting for a further 2.2% of deaths (n=5). Alcohol was detected in 41% of deaths by suicide (n=12), 50% of road traffic collision victims (n=1), 50% of non-alcohol drug overdoses (n=8) and 13% of sudden natural deaths (n=21). Of those autopsies in which the cause of death remained undetermined, alcohol was detected in 50% of cases (n=3) and was considered of significance in 33% (n=2).
Conclusions: Direct effects of acute and chronic alcohol consumption accounted for 4% of all coronial deaths in our autopsy practice. However alcohol was detected in 45% of all other unnatural deaths (suicide, RTA, non-alcohol drug overdoses). Of particular note was its presence in 41% of deaths by suicide. It also played a significant role in deaths whose cause remained unascertained. Death registration globally tends to simplify causes of mortality to the main cause and the external cause of death only. We feel that as a result of this, alcohol-related deaths, in particular the contribution of alcohol to death by suicide, are underestimated. Increased awareness of the frequent contributory role that alcohol plays in all causes of death is required to direct adequate preventative public health strategies.
Monday, March 4, 2013 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 3, Monday Morning