All-cause and cause-specific mortality in individuals with an alcohol-related emergency or hospital inpatient presentation: A retrospective data linkage cohort study.

Autor: Leung J; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia., Chiu V; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia., Man N; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia., Yuen WS; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia., Dobbins T; School of Population Health, UNSW Sydney, Sydney, NSW, Australia., Dunlop A; Hunter New England Health, New South Wales Government, Newcastle, NSW, Australia., Gisev N; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia., Hall W; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia., Larney S; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.; Department of Family Medicine and Emergency Medicine, University of Montréal, Montréal, QC, Canada.; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada., Pearson SA; Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, NSW, Australia., Degenhardt L; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia., Peacock A; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Addiction (Abingdon, England) [Addiction] 2023 Sep; Vol. 118 (9), pp. 1751-1762. Date of Electronic Publication: 2023 May 16.
DOI: 10.1111/add.16218
Abstrakt: Background and Aims: Alcohol consumption is a leading risk factor for premature mortality globally, but there are limited studies of broader cohorts of people presenting with alcohol-related problems outside of alcohol treatment services. We used linked health administrative data to estimate all-cause and cause-specific mortality among individuals who had an alcohol-related hospital inpatient or emergency department presentation.
Design: Observational study using data from the Data linkage Alcohol Cohort Study (DACS), a state-wide retrospective cohort of individuals with an alcohol-related hospital inpatient or emergency department presentation.
Setting: Hospital inpatient or emergency department presentation in New South Wales, Australia, between 2005 and 2014.
Participants: Participants comprised 188 770 individuals aged 12 and above, 66% males, median age 39 years at index presentation.
Measurements: All-cause mortality was estimated up to 2015 and cause-specific mortality (by those attributable to alcohol and by specific cause of death groups) up to 2013 due to data availability. Age-specific and age-sex-specific crude mortality rates (CMRs) were estimated, and standardized mortality ratios (SMRs) were calculated using sex and age-specific deaths rates from the NSW population.
Findings: There were 188 770 individuals in the cohort (1 079 249 person-years of observation); 27 855 deaths were recorded (14.8% of the cohort), with a CMR of 25.8 [95% confidence interval (CI) = 25.5, 26.1] per 1000 person-years and SMR of 6.2 (95% CI = 5.4, 7.2). Mortality in the cohort was consistently higher than the general population in all adult age groups and in both sexes. The greatest excess mortality was from mental and behavioural disorders due to alcohol use (SMR = 46.7, 95% CI = 41.4, 52.7), liver cirrhosis (SMR = 39.0, 95% CI = 35.5, 42.9), viral hepatitis (SMR = 29.4, 95% CI = 24.6, 35.2), pancreatic diseases (SMR = 23.8, 95% CI = 17.9, 31.5) and liver cancer (SMR = 18.3, 95% CI = 14.8, 22.5). There were distinct differences between the sexes in causes of excess mortality (all causes fully attributable to alcohol female versus male risk ratio = 2.5 (95% CI = 2.0, 3.1).
Conclusions: In New South Wales, Australia, people who came in contact with an emergency department or hospital for an alcohol-related presentation between 2005 and 2014 were at higher risk of mortality than the general New South Wales population during the same period.
(© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
Databáze: MEDLINE
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