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09-12-2010 | Gastroenterology | Article

Gallstone disease associated with increased mortality in US population


Free abstract

MedWire News: Results from the third US National Health and Nutrition Examination Survey (NHANES III) suggest that people with gallstone disease have increased overall, cardiovascular disease (CVD), and cancer mortality compared with the general population.

Constance Ruhl (Social and Scientific Systems, Inc., Silver Spring, Maryland, USA) and James Everhart (National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA) evaluated 18 years or more of mortality data from NHANES III on 14,228 individuals who underwent gallbladder ultrasonography between 1988 and 1994. The participants were aged 20-74 years.

The researchers defined gallbladder disease as evidence of gallstones or cholecystectomy on ultrasound. In total, 7.1% of the participants had gallstones and 5.3% had evidence of cholecystectomy.

Causes of death during the 18-year follow-up period (until 2006) were ascertained from death certificates. During this time, 16.5% of the cohort died from any cause, 6.7% from CVD, and 4.9% from cancer.

All-cause, CVD-, and cancer-related mortality were a significant and respective 30%, 40%, and 30% higher in patients with gallbladder disease than in those without, report the investigators in the journal Gastroenterology.

Of note, little difference in mortality was observed between patients with gallstones and those with cholecystectomy, and both had a similarly increased risk for death compared with the general population.

"In the current study, reasons for the increase in mortality, especially cardiovascular mortality, related to gallstones are uncertain," write Ruhl and Everhart.

"Nevertheless, it is likely that mechanisms of gallbladder disease share features in common with mechanisms of cardiovascular disease and other common causes of death."

They conclude: "Further study is needed to determine whether increased mortality results from some unmeasured factor responsible for gallstone development."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert