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在隆德比社区队列中酒精使用障碍的死亡率——50 年随访。

Mortality in alcohol use disorder in the Lundby Community Cohort--a 50 year follow-up.

机构信息

Department of Clinical Sciences, Lund Division of Psychiatry, the Lundby Study, Lund University, SE-221 85 Lund, Sweden.

出版信息

Drug Alcohol Depend. 2011 Nov 1;118(2-3):141-7. doi: 10.1016/j.drugalcdep.2011.03.008. Epub 2011 Apr 6.

Abstract

AIMS

To describe the mortality and causes of death among subjects with alcohol use disorder in comparison with those without alcohol disorder and to study whether mental disorders increase mortality in alcoholics.

DESIGN AND SETTING

Data were analysed from the database of the Lundby Study, comprising 3563 subjects followed from 1947 to 1997.

METHOD

A community-based sample was investigated in 1947 with follow-ups in 1957, 1972 and 1997. Best-estimate consensus diagnoses of mental disorders, including alcohol use disorder, were assessed. In the total cohort, 427 cases of alcohol use disorders were identified. Differences in mortality between subjects with alcohol use disorders and non-alcoholics were studied using Cox regression models and causes of death were compared between alcoholic subjects and other participants. Risk factors for mortality among the 348 individuals with alcohol use disorders and known age-of-onset were analysed by means of Cox regression analyses.

RESULTS

The hazard ratio for mortality was higher for alcoholics compared to other subjects in the cohort. A substantial proportion of the causes of death among the alcoholics was suicide N=27 (6.3%) (26 males, 1 female). In the multivariate models of risk factors in alcohol use disorders, anxiety disorders, psychotic disorders, alcohol induced psychotic disorders and dementia were risk factors for premature death.

CONCLUSION

The mortality risk for subjects with alcohol use disorder was increased, females were especially vulnerable. The risk for suicide was high among males with alcohol problems. Anxiety disorders and severity of alcohol use disorder turned out as risk factors for premature death.

摘要

目的

描述酒精使用障碍患者的死亡率和死因,并研究精神障碍是否会增加酗酒者的死亡率。

设计和设置

数据来自隆德比研究数据库,该研究包含了从 1947 年至 1997 年随访的 3563 名受试者。

方法

对 1947 年进行的一项基于社区的样本进行了调查,并在 1957 年、1972 年和 1997 年进行了随访。对精神障碍(包括酒精使用障碍)的最佳估计共识诊断进行了评估。在总队列中,确定了 427 例酒精使用障碍病例。使用 Cox 回归模型研究了酒精使用障碍患者与非酗酒者之间的死亡率差异,并比较了酗酒者和其他参与者之间的死因。通过 Cox 回归分析对已知发病年龄的 348 名酒精使用障碍患者的死亡率危险因素进行了分析。

结果

与队列中的其他受试者相比,酗酒者的死亡率风险更高。酗酒者的死因中,自杀的比例相当高(N=27,6.3%)(26 名男性,1 名女性)。在酒精使用障碍的多变量危险因素模型中,焦虑障碍、精神病性障碍、酒精所致精神病性障碍和痴呆是早逝的危险因素。

结论

酒精使用障碍患者的死亡风险增加,女性尤其脆弱。有酒精问题的男性自杀风险较高。焦虑障碍和酒精使用障碍的严重程度是早逝的危险因素。

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