Kinder Leslie S, Bryson Chris L, Sun Haili, Williams Emily C, Bradley Katharine A
Northwest Center of Excellence for Health Services Research and Development, Department of Veterans Affairs, 1100 Olive Way, Suite 1400, Seattle, Washington 98101, USA.
J Stud Alcohol Drugs. 2009 Mar;70(2):253-60. doi: 10.15288/jsad.2009.70.253.
Extensive research demonstrates a J- or U-shaped association between in-depth interview measures of alcohol consumption and mortality. Little is known about the relationship between alcohol screening questionnaires and mortality. This study examined the association between scores (ranging from 0 to 12) on the three-item Alcohol Use Disorder Identification Test-Consumption Questionnaire (AUDIT-C) and mortality.
This cohort study included male outpatients from seven Veterans Affairs (VA) medical centers who completed the AUDIT-C on mailed surveys (1997-2000; n=34,292) and who were followed for a mean of 2.5 years. Death was ascertained from VA databases.
In analyses adjusted for demographics, a U-shaped relationship was observed between AUDIT-C scores and all-cause mortality. Nondrinkers (AUDIT-C 0) and heavy drinkers (AUDIT-C 8-9 and 10-12) had increased risk of death compared with drinkers who screened negative for alcohol misuse (AUDIT-C 1-3): hazard ratios (HR)=1.41 (95% confidence interval [CI]: 1.29-1.54), 1.32 (1.03-1.69), and 1.47 (1.14-1.91), respectively. This association differed across age groups (p=.003). For men younger than 50 years, AUDIT-C scores 10-12 were associated with increased mortality (HR=2.21, 95% CI: 1.29-3.77), whereas for men age 50 or older, self-reported abstinence (AUDIT-C 0) was associated with increased mortality, compared with drinkers with AUDIT-C scores 1-3: HR formen 50-64=1.45 (1.19-1.77); HR for men 65 or older=1.42 (1.28-1.58).
A U-shaped association between the AUDIT-C and mortality was observed, with important differences by age group. This is the first study to demonstrate that a clinical scaled screening measure of alcohol use has a similar association with mortality to that observed in epidemiological research with lengthier measures.
大量研究表明，酒精摄入量的深入访谈测量值与死亡率之间呈J形或U形关联。关于酒精筛查问卷与死亡率之间的关系，人们了解甚少。本研究考察了三项饮酒障碍识别测试-消费问卷（AUDIT-C）的得分（范围为0至12分）与死亡率之间的关联。
这项队列研究纳入了来自七个退伍军人事务（VA）医疗中心的男性门诊患者，他们在邮寄调查中完成了AUDIT-C（1997 - 2000年；n = 34292），并平均随访了2.5年。通过VA数据库确定死亡情况。
在对人口统计学因素进行调整的分析中，观察到AUDIT-C得分与全因死亡率之间呈U形关系。与酒精滥用筛查呈阴性的饮酒者（AUDIT-C 1 - 3）相比，不饮酒者（AUDIT-C 0）和重度饮酒者（AUDIT-C 8 - 9和10 - 12）的死亡风险增加：风险比（HR）分别为1.41（95%置信区间[CI]：1.29 - 1.54）、1.32（1.03 - 1.69）和1.47（1.14 - 1.91）。这种关联在不同年龄组中存在差异（p = 0.003）。对于年龄小于50岁的男性，AUDIT-C得分10 - 12与死亡率增加相关（HR = 2.21，95%CI：1.29 - 3.77），而对于年龄50岁及以上的男性，与AUDIT-C得分1 - 3的饮酒者相比，自我报告戒酒（AUDIT-C 0）与死亡率增加相关：50 - 64岁男性的HR = 1.45（1.19 - 1.77）；65岁及以上男性的HR = 1.42（1.28 - 1.58）。
观察到AUDIT-C与死亡率之间呈U形关联，并在不同年龄组中存在重要差异。这是第一项表明酒精使用的临床量表筛查测量与死亡率之间的关联与使用更长测量方法的流行病学研究中观察到的关联相似的研究。
