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

David Bergman; Hannes Hagström; Andrea Johansson Capusan; Karl Mårild; Fredrik Nyberg; Kristina Sundquist; Jonas F Ludvigsson

doi:10.2147/CLEP.S285936

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

Clin Epidemiol. 2020 Dec 31:12:1433-1442. doi: 10.2147/CLEP.S285936. eCollection 2020.

Authors

David Bergman¹, Hannes Hagström^{2

3

4}, Andrea Johansson Capusan^{5

6}, Karl Mårild^{7

8}, Fredrik Nyberg⁹, Kristina Sundquist¹⁰, Jonas F Ludvigsson^{1

11

12

13}

Affiliations

¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
² Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
³ Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
⁴ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
⁵ Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
⁶ Department of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
⁷ Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
⁸ Department of Pediatric Gastroenterology, Queen Silvia Children's Hospital, Gothenburg, Sweden.
⁹ School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁰ Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
¹¹ Department of Pediatrics, Orebro University Hospital, Orebro, Sweden.
¹² Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
¹³ Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Abstract

Aim: 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 drinking; alcohol use disorder; alcohol-related disease; drug use; ethanol.

Grants and funding

The study did not receive any external funding.