Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
Am J Epidemiol. 2012 Feb 15;175(4):302-8. doi: 10.1093/aje/kwr318. Epub 2012 Jan 6.
This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.
本研究考察了加利福尼亚州旧金山年轻注射吸毒者的死亡率与人口统计学和风险特征之间的关联，并将死亡率与人群死亡率进行了比较。共有 644 名年轻 (<30 岁) 的注射吸毒者完成了基线访谈，并于 1997 年 11 月至 2007 年 12 月参加了一项名为 UFO（“U 找出来”）研究的前瞻性队列研究。作者利用国家死亡指数，在 4167 人年的随访中发现了 38 例死亡，死亡率为 9.1（95%置信区间：6.6，12.5）/1000 人年。这一死亡率是普通人群的 10 倍。主要死因是过量用药（57.9%）、自残（13.2%）、创伤/事故（10.5%）和与注射吸毒者相关的医疗状况（13.1%）。在过去一个月中报告每天多数天注射海洛因的人中，死亡率显著更高（调整后的危险比=5.8，95%置信区间：1.4，24.3）。该组的主要死因是过量用药，海洛因的主要使用是该研究中观察到的死亡的唯一显著危险因素。这些发现强调了需要采取公共卫生干预措施，以减少该人群的过量用药风险，从而降低过早死亡的风险。
