Clinical Epidemiology (Dec 2020)

Incidence of ICD-Based Diagnoses of Alcohol-Related Disorders and Diseases from Swedish Nationwide Registers and Suggestions for Coding

  • Bergman D,
  • Hagström H,
  • Capusan AJ,
  • Mårild K,
  • Nyberg F,
  • Sundquist K,
  • Ludvigsson JF

Journal volume & issue
Vol. Volume 12
pp. 1433 – 1442

Abstract

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David Bergman,1 Hannes Hagström,2– 4 Andrea Johansson Capusan,5,6 Karl Mårild,7,8 Fredrik Nyberg,9 Kristina Sundquist,10 Jonas F Ludvigsson1,11– 13 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 2Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden; 3Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; 4Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; 5Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; 6Department of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; 7Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; 8Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; 9School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 10Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden; 11Department of Pediatrics, Orebro University Hospital, Orebro, Sweden; 12Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; 13Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USACorrespondence: Jonas F LudvigssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, SwedenEmail [email protected]: To improve consistency between register studies in Sweden and ensure valid comparisons of possible changes in alcohol-related disorders and diseases (ARDDs) over time, we propose a definition of ARDDs. Based on this definition, we examined Sweden’s incidence rates of ARDDs from 1970 to 2018 in non-primary healthcare settings (inpatient and outpatient).Methods: Swedish Society of Epidemiology members were invited to give feedback on the International Classification of Disease (ICD) codes with a potential link to alcohol use. We then calculated age-standardised and age-specific incidence of ARDDs over time according to the National Patient Register, and the lifetime prevalence of ARDDs diagnosed in adults alive in Sweden on Dec 31, 2018.Results: Sweden’s estimated incidence of ARDDs increased substantially after introducing the new ICD-9 codes in 1987. In the past 10 years (2009– 2018), the incidence of ARDDs has been stable (males: 110/100,000 person-years, females: 49/100,000 person-years). Requiring at least two ICD records for diagnosed ARDDs led to a somewhat lower incidence of ARDDs (males: 71 per 100,000 person-years, females: 29 per 100,000 person-years). In Sweden, the lifetime prevalence of diagnosed ARDDs in adults on Dec 31, 2018, was 1.9% (95% CI=1.9– 1.9).Conclusion: In this nationwide study, we found an incidence of ARDDs of 50– 100/100,000 person-years. In 2018, 1 in 52 adults in Sweden had been diagnosed with ARDDs in the National Patient Register.Keywords: alcohol, alcohol use disorder, alcohol-related disease, alcohol drinking, drug use, ethanol

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