Liver pathologies in the structure of deaths from gastrointestinal diseases in Krasnodar Krai in 2014–2018

Abstract

Aim. To determine the frequency of liver pathologies among the causes of death from gastrointestinal diseases in Krasnodar Krai in 2014–2018.Materials and methods. The prevalence of liver pathologies in the structure of deaths from gastrointestinal diseases was studied according to the annual reports of the Bureau of Forensic Medical Examination of the Ministry of Health of Krasnodar Krai (FME Bureau), medical certificates of death (form No. 106/U-08) issued by forensic experts and registered in the mortality monitoring database (Parus information system), and data obtained from the Medical Information Analytical Centre of Krasnodar Krai for 2014-2018.Results. Liver pathologies account for more than 50% cases in the structure of mortality from gastrointestinal diseases. More frequently, this reason caused death in 50–60 year old men and 60–65 year old women. Liver pathologies were found mainly in urban residents. It is noteworthy that, in the studied period, such deaths most frequently occurred at home, on the street, in public transport, etc.; only about 15% of patients died in hospitals. Among the registered liver diseases leading to death (ICD 10, headings K70–K77), cirrhosis of various etiologies was the leading cause, with “unspecified cirrhosis” being ranked the first place. Over the studied period, this cause of death showed a growing trend. Thus, 67.12%, 74.59%, 89.58% and 85.12% of such cases were registered in 2015, 2016, 2017 and 2018, respectively. In 2014–2016, cirrhosis and liver fibrosis (code K74), and alcoholic cirrhosis (code K70.3) were ranked the 2nd and 3rd more frequent death cause, respectively. Since 2017, alcoholic cirrhosis of the liver has occupied the 2nd place. However, over the 2014–2018 period, a decrease in the frequency of cirrhosis of alcoholic etiology was noted: its share was 10.52% of all cirrhosis in 2015, decreasing to 10.17%, 6.59%, 4.86% and 4.39% in 2015, 2016, 2017 and 2018, respectively.Conclusion. Although mortality due to gastrointestinal diseases continues to decrease, liver pathologies remain to be the leading cause in 50% of such deaths. The leading disease is cirrhosis and unspecified liver fibrosis. According to the FME Bureau, deaths from cirrhosis occur outside hospitals in more than 85% of cases. The absence of cirrhosis verification by the etiological factor during autopsy requires the development of an algorithm of action, which should include a full-fledged investigation of the corpse, subsequent histological examination, assessment of pathomorphological signs taking into account clinical and medical history data and exclusion of the viral process by conducting serological tests.