Clinical—Liver, Pancreas, and Biliary TractGallstone Disease Is Associated With Increased Mortality in the United States
Section snippets
Methods
NHANES III was conducted in the United States from 1988 through 1994 by the National Center for Health Statistics of the Centers for Disease Control and Prevention.9 It consisted of a cross-sectional interview, examination, and laboratory data collected from a complex multistage, stratified, clustered probability sample representative of the civilian, noninstitutionalized population with oversampling of persons aged 60 years and older, African Americans, and Hispanics. The survey was approved
Results
The prevalence (±SE) of gallstones was 7.1% (±0.38%) and cholecystectomy 5.3% (±0.29%). Because participants with gallstone disease tended to be considerably older than those without (mean, 53.2 years vs 40.7 years; P < .001), other baseline characteristics were compared, adjusted for age (Table 1). In contrast to participants without gallstone disease, those with gallstone disease were more likely to be female, Mexican-American, diabetic, less educated and less physically active, have a higher
Discussion
The main finding of this study was an association of gallstone disease with overall, cardiovascular disease, and cancer mortality in a large, national, population-based, prospective study. For overall and cardiovascular disease mortality, this was a consistent finding in both age-adjusted and multivariate-adjusted analyses. For cancer mortality, the strength of the relationship was unchanged but did not reach statistical significance in multivariate-adjusted analysis. Similar to our results, a
Acknowledgments
The National Center for Health Statistics (NCHS) was the source for the National Health and Nutrition Examination Survey III Linked Mortality Files. All analyses, interpretations, and conclusions are those of the authors and not NCHS. The authors thank Negasi Beyene for assistance in using the NCHS Research Data Center, Tempie Shearon, Lead Research Area Specialist, Kidney Epidemiology and Cost Center, University of Michigan for assistance with programming for creation of the survival curve
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Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by a contract from the National Institute of Diabetes and Digestive and Kidney Diseases (HHSN267200700001G).