Newswise — Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States between 2010 and 2016, alcohol-related liver disease was the primary cause of nearly 1 in 3 liver transplants, surpassing hepatitis C.

Researchers from Florida Atlantic University’s Schmidt College of Medicine conducted an original research study utilizing the U.S. Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (WONDER) to compare trends in mortality from alcoholic cirrhosis in the U.S. in 1999 with those 20 years later in 2019. They calculated mortality rates and mortality rate ratios (MRRs) per 100,000 from alcoholic cirrhosis in 10-year age groups from ages 25 to 85 and older as measures of effect and 95 percent confidence intervals to test for significance.

Results of the study, published online ahead of print in The American Journal of Medicine, showed that in 1999 there were 6,007 deaths from alcoholic cirrhosis among 180,408,769 Americans ages 25 to 85 and older yielding a mortality rate of 3.3 per 100,000. In 2019, there were 23,780 deaths from alcoholic cirrhosis among 224,981,167 Americans ages 25 to 85 and older, yielding a mortality rate of 10.6 per 100,000.

“It is very sobering that in the United States between 1999 and 2019, we saw a greater than three-fold increase in deaths from alcoholic cirrhosis,” said Lawrence Fiedler, M.D., co-author, a board-certified practicing gastroenterologist and an affiliate associate professor in FAU Schmidt College of Medicine. “Damage from chronic and excessive alcohol intake results in fatty liver disease and alcoholic hepatitis. Over time, this results in scarring and cirrhosis, the final and irreversible phase of alcoholic liver disease.”

In the U.S. between 1999 and 2019 there also were statistically significant increases in mortality from alcoholic cirrhosis in each 10-year age group from 25 to 85 and older. It also is notable that the largest increase was seven-fold in the age group 24 to 35 years and that the steepest increase was among those ages 65 to 74.

“While more research in necessary, these alarming trends in mortality from alcoholic cirrhosis pose immediate clinical and public health challenges to curb the epidemics of heavy alcohol consumption as well as overweight and obesity and lack of physical activity in the U.S., all of which may be contributory,” said Charles H. Hennekens, M.D., Dr.PH, corresponding author, first Sir Richard Doll Professor of Medicine and senior academic adviser, FAU Schmidt College of Medicine.   

The researchers note that primary care providers may want to counsel all their patients that individuals who consume large amounts of alcohol have the highest mortality rates from both cirrhosis and cardiovascular disease. While the data indicate that those who select one to two drinks daily have lower risks of cardiovascular disease than nondrinkers, it is also true that the difference between drinking smaller and larger amounts of alcohol means the difference between preventing and causing premature death. 

“Specifically, rates of myocardial infarction and stroke as well as hypertension, hemorrhagic stroke and breast cancer all begin to rise above one drink daily, especially in women,” said Hennekens. “In addition, the impacts of increased alcohol consumption at earlier ages as well as overweight and obesity and lack of physical activity all may contribute, alone and in combination, to the observed increases in mortality from alcoholic cirrhosis.”

Study co-authors are Orly Termei, first-year FAU medical student; Lisa Martinez, M.D.; Jennifer Foster, M.D.; and Parvathi Perumareddi, D.O., all associate professors of medicine, FAU Schmidt College of Medicine.

- FAU -

About the Charles E. Schmidt College of Medicine:

FAU’s Charles E. Schmidt College of Medicine is one of approximately 155 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 70 full and part-time faculty and more than 1,300 affiliate faculty, the college matriculates 64 medical students each year and has been nationally recognized for its innovative curriculum. To further FAU’s commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. The Consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residencies including internal medicine, surgery, emergency medicine, psychiatry, and neurology. The college’s vibrant research focus areas include healthy aging, neuroscience, chronic pain management, precision medicine and machine learning. With community at the forefront, the college offers the local population a variety of evidence-based, clinical services that treat the whole person. Jointly, FAU Medicine’s Primary Care practice and the Marcus Institute of Integrative Health have been designed to provide complete health and wellness under one roof.


About Florida Atlantic University: Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit


Journal Link: The American Journal of Medicine