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Agnieszka Fihel, Sergi Trias-Llimos, Magdalena M. Muszyńska, Markéta Majerova. 2023.

Alcohol-related mortality in four European countries:A multiple-cause-of-death study

 

Drug and Alcohol Review (DAR) Volume 42, Issue 4 May 2023 | pages: 938-945

Key Points

  • Multiple-cause mortality linked to alcohol is almost double that of mortality with alcohol as the underlying cause in Austria, Czechia and Spain, but not in Poland.
  • Liver diseases are the most common underlying and multiple causes of death, but the multiple causes of death approach evidences the importance of mental and behavioural disorders that are relatively frequently certified as contributory to other, non-alcohol-related conditions.
  • Different patterns of cause-, sex- and age-specific mortality are observed in Czechia and Poland with a relatively high preference for spirits, and Austria and Spain with a strong prevalence of wine consumption.

https://doi.org/10.1111/dar.13624


Abstract

The impact of conditions that partly or indirectly contribute to drinking-related mortality is usually underestimated. We investigate all alcohol-related multiple (underlying and contributory) causes of death and compare mortality distributions in countries with different levels and patterns of drinking. Analysis of population-level mortality data for persons aged 20 and over in Austria, Czechia, Poland and Spain. Age-standardised death rates and standardised ratios of multiple to underlying cause were calculated for alcohol-related causes of death. Multiple-cause mortality ranged from 20 to 58 deaths per 100,000 for men and from 5 to 16 per 100,000 for women. Liver diseases were the most common underlying and multiple causes, but mental and behavioural disorders were the second or third, depending on country and sex, most prevalent multiple mentions. Two distinct age patterns of alcohol-related mortality were observed: in Czechia and Poland an inverted-U distribution with a peak at the age of 60–64, in Austria and Spain a distribution increasing with age and then levelling off for older age groups. The importance of alcohol-related conditions that indirectly impact mortality can be re-assessed with the use of contributory mentions. The multiple-cause-of-death approach provides convergent results for countries characterised by similar patterns of alcohol consumption. Multiple-cause mortality was almost double the level of mortality with alcohol as the underlying cause, except in Poland. Mental and behavioural disorders were mostly certified as contributory to other, non-alcohol-related underlying causes of death.
 

Keywords

The impact of conditions that partly or indirectly contribute to drinking-related mortality is usually underestimated. We investigate all alcohol-related multiple (underlying and contributory) causes of death and compare mortality distributions in countries with different levels and patterns of drinking.