Characteristics, toxicology and major organ pathology of deaths due to acute alcohol toxicity in Australia, 2011-2022

Drug Alcohol Rev. 2024 May;43(4):937-945. doi: 10.1111/dar.13817. Epub 2024 Feb 12.

Abstract

Introduction: Acute alcohol toxicity is a significant component of alcohol-related mortality. The study aimed to: (i) determine the circumstances of death and characteristics of fatal alcohol toxicity cases, 2011-2022; (ii) determine their toxicological profile and major autopsy findings; and (iii) determine trends in population mortality rates.

Methods: Retrospective study of acute alcohol toxicity deaths in Australia, 2011-2022, retrieved from the National Coronial Information System.

Results: A total of 891 cases were identified, with a mean age of 49.2 years, 71.0% being male. Alcohol use problems were noted in 71.3%. In 57.5% death was attributed solely to acute alcohol toxicity, and combined acute alcohol toxicity/disease in 42.5%. There was evidence of sudden collapse in 24.9% of cases. The mean BAC was 0.331 g/100 mL (range 0.107-0.936), and spirits were the most commonly reported beverages (35.8%). Cases of combined toxicity/disease had significantly lower BACs than those attributed solely to alcohol toxicity (0.296 vs. 0.358 g/100 mL). Cardiomegaly was diagnosed in 32.5%, and severe coronary artery disease in 22.1%. Aspiration of vomitus was noted in 18.0%, and chronic obstructive pulmonary disease in 19.6%. Severe liver steatosis was present in 33.4% and 13.6% had cirrhosis. There was an average annual percentage increase in deaths of 7.90.

Discussion and conclusions: The 'typical' case was a long-standing, heavy spirits drinker. BACs showed enormous variation and no arbitrary concentration may be deemed lethal. Clinically significant disease was associated with death at a lower BAC and people with such disease may be at increased risk of alcohol poisoning.

Keywords: alcohol; circumstance; disease; mortality; toxicology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / mortality
  • Alcohol Drinking / trends
  • Alcoholic Beverages / adverse effects
  • Australia / epidemiology
  • Autopsy
  • Blood Alcohol Content*
  • Cause of Death / trends
  • Ethanol / adverse effects
  • Ethanol / poisoning
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult

Substances

  • Blood Alcohol Content
  • Ethanol