Bird Sheila M, Hutchinson Sharon J, Goldberg David J
MRC Biostatistics Unit, Cambridge, UK.
Lancet. 2003 Sep 20;362(9388):941-4. doi: 10.1016/S0140-6736(03)14362-0.
In 2000 and 2001, there were 292 and 332 drug-related deaths in Scotland, respectively. Of the 332 people who died in 2001, 65 were of female sex, 80 were younger than 25 years, and 112 were older than 34 years. We assessed the effect of region, sex, and age group on drug-related deaths in Scotland per 100 injecting drug users.
We used published regional estimates of current injecting drug users (n=22805), their sex (30% female) and age distribution (8% older than 34 years in mid-1990s), or corresponding data for problem drug users (21% older than 34 years in 2000) to compare observed with expected drug-related deaths by region, sex, and age group per 1000 population or per 100 injecting drug users.
Regional population-based expectations fitted poorly to observed drug-related deaths, but those based on injecting drug users fitted tolerably. Drug-related deaths in 2001 per 100 injecting drug users were significantly lower in female (0.9 [95% CI 0.6-1.1]) than in male drug users (1.5; 1.3-1.7). They were between two and six times more frequent per 100 injecting drug users older than 34 years than younger than 25 years, depending on whether current injecting drug users' age distribution was assumed to be the same as problem drug users' or as injecting drug users' in the mid-1990s (2.1 [1.7-2.5] or 5.3 [4.3-6.3], respectively).
Older and male injecting drug users were at highest risk of drug-related death. Injecting drug users' age distribution should be assessed and compared across countries.
2000年和2001年,苏格兰分别有292例和332例与药物相关的死亡案例。在2001年死亡的332人中,65人为女性,80人年龄小于25岁,112人年龄大于34岁。我们评估了地区、性别和年龄组对苏格兰每100名注射吸毒者中与药物相关死亡的影响。
我们使用已公布的当前注射吸毒者的地区估计数(n = 22805)、他们的性别(30%为女性)和年龄分布(20世纪90年代中期8%年龄大于34岁),或问题吸毒者的相应数据(2000年21%年龄大于34岁),以比较按地区、性别和年龄组每1000人口或每100名注射吸毒者观察到的与预期的药物相关死亡情况。
基于地区人口的预期与观察到的药物相关死亡情况拟合不佳,但基于注射吸毒者的预期拟合尚可。2001年每100名注射吸毒者中,女性的药物相关死亡人数(0.9 [95%可信区间0.6 - 1.1])显著低于男性吸毒者(1.5;1.3 - 1.7)。根据假设当前注射吸毒者的年龄分布与问题吸毒者相同还是与20世纪90年代中期注射吸毒者相同,每100名年龄大于34岁的注射吸毒者中药物相关死亡的频率比年龄小于25岁的注射吸毒者高两到六倍(分别为2.1 [1.7 - 2.5]或5.3 [4.3 - 6.3])。
年龄较大和男性注射吸毒者与药物相关死亡的风险最高。应评估并比较各国注射吸毒者的年龄分布。