Epidemiology

Chronic heavy alcohol consumption may result in ARLD, which is a major cause of advanced liver disease and liver-related mortality worldwide.[1]

According to the Centers for Disease Control and Prevention, in the US, around 17% adults binge drink (have four or more drinks [women] or five or more drinks [men] on an occasion) and around 6% adults drink heavily (have eight or more drinks [women] or 15 or more drinks [men] in a week).​[2]

​Chronic alcohol consumption is a significant cause of mortality, morbidity, and social problems, and accounted for approximately 2.6 million deaths worldwide in 2019.[3][4]

In 2020-2021, excess alcohol consumption led to approximately 178,000 deaths and reduced the average lifespan by 24 years.[2]

An increase in ARLD prevalence has been noted since 2014, with an accelerated increase observed during the COVID-19 pandemic.[1]​ The highest increase in prevalence of alcohol use disorder and ARLD was noted in younger adults, women, and minorities.[1]

One US modelling study of high-risk alcohol drinking patterns suggests that age-standardised deaths due to ARLD are expected to increase from 8.2 per 100,000 person-years in 2019 to 15.2 per 100,000 person-years in 2040.[5]

In 2022, the US National Survey on Drug Use and Health reported that 28.1 million adults aged ≥18 years (10.9% of this age group) had alcohol use disorder.[6][7] Of these, 16.6 million were men (13.2% of men in this age group).[6][7]

In the UK, in 2022, 50.3 hospital admissions per 100,000 population (27,419 admissions) for ARLD were reported, which is 65% higher than those reported in 2012 (16,571 admissions).[8]

In England, in 2020, liver disease and liver cancer together caused 2.5% of deaths; almost half of these deaths occurred in those of working age (aged 15-64 years).[9]​ ARLD alone caused more than 50,000 years-of-life lost in 2020. Mortality rates for ARLD in people aged <75 years have increased by almost 45% between 2001 and 2020.[9]

One systematic review and meta-analysis found that the prevalence of ARLD and proportions of alcohol-attributable cirrhosis and hepatocellular carcinoma are lower in Asia, compared with western countries.[10]

Alcohol-related hepatitis is a less common stage of ARLD having high mortality, with population level estimates of annual incidence at 25-45 per 100,000 person-years.[11]

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