Guitart Anna M, Espelt Albert, Castellano Yolanda, Bartroli Montse, Villalbí Joan R, Domingo-Salvany Antonia, Brugal M Teresa
Agència de Salut Pública de Barcelona, España.
Gac Sanit. 2011 Sep-Oct;25(5):385-90. doi: 10.1016/j.gaceta.2011.03.019. Epub 2011 Jul 30.
To estimate excess mortality in patients with an alcohol use disorder and to calculate the population-based impact attributable to this disorder, with emphasis on differences according to gender and age.
We carried out a longitudinal study of a dynamic retrospective cohort in which 7,109 patients (76.5% men) aged 18-64 years who started medical day treatment between 1997 and 2006 were recruited. Deaths were monitored until the end of 2006 using a national mortality register. Standardized mortality ratios (SMR) by age and gender and population attributable risks (PAR) by age group were estimated.
There were 557 deaths (83% were men). The total excess mortality was 8 times higher than in the general population aged 18-64 years, especially in the group aged 25-34 years old (SMR: 11.2 [95% CI: 7.8-16.0] in men and 24 [IC95%: 11.5-50.4] in women). Significant differences by gender were found in all the variables analyzed. In Barcelona, alcohol use disorder was estimated to cause 73 deaths per year, representing 3.3% of the total annual deaths in this city in persons aged 18-64 years. This percentage was substantially higher in the groups aged 25-34 years (PAR: 19.4% [95% CI: 19.2-19.6]) and 18-24 years (PAR: 11.1% [95% CI: 10.7-11.4]).
Women and young men with an alcohol use disorder have a higher risk of early mortality. Early detection of problematic alcohol consumption and selective and well-indicated prevention programs should be improved.
评估酒精使用障碍患者的超额死亡率，并计算该障碍对人群的影响，重点关注性别和年龄差异。
我们对一个动态回顾性队列进行了纵向研究，招募了1997年至2006年间开始接受日间医疗治疗的7109名18至64岁患者（76.5%为男性）。使用国家死亡率登记册监测死亡情况直至2006年底。估计了按年龄和性别划分的标准化死亡率（SMR）以及按年龄组划分的人群归因风险（PAR）。
共有557人死亡（83%为男性）。总超额死亡率比18至64岁的普通人群高8倍，尤其是在25至34岁年龄组（男性SMR：11.2 [95%可信区间：7.8 - 16.0]，女性为24 [95%可信区间：11.5 - 50.4]）。在所有分析变量中均发现了显著的性别差异。在巴塞罗那，估计酒精使用障碍每年导致73人死亡，占该市18至64岁人群年度总死亡人数的3.3%。这一比例在25至34岁年龄组（PAR：19.4% [95%可信区间：19.2 - 19.6]）和18至24岁年龄组（PAR：11.1% [95%可信区间：10.7 - 11.4]）中显著更高。
患有酒精使用障碍的女性和年轻男性过早死亡风险更高。应改进对有问题饮酒的早期检测以及针对性强且指示明确的预防项目。
