The Increasing Mortality Attributed to Cirrhosis and Fatty Liver, in Baltimore (1957-1966)

A study of cirrhosis mortality among young adults (ages 25 to 44) in Baltimore between 1957 and 1966 was completed by reviewing death certificates, medical examiners' reports, and autopsy protocols. The study showed a substantial increase in cirrhosis mortality. This increase has been greatest for negro women (259.7%). Death rates were higher in negroes than in whites and in men as compared with women. Rates were also higher in lower social classes. The increase in cirrhosis mortality rates was primarily a consequence of a greater number of deaths certified by the medical examiner as being caused by cirrhosis. These certified deaths were compared with those not so certified. They were usually sudden and unexpected and occurred outside of a hospital, while those not certified occurred in a hospital and were not sudden. The principal pathologic finding in the certified deaths was a large fatty liver, while for those not certified a cirrhotic liver was the usual pathologic finding. There was little change in the death rates that were not sudden, and there was a substantial increase in the sudden-death rate.