Alcohol Research Group , Emeryville, California; Centre for Addictions Research of BC , University of Victoria, Victoria, BC, Canada.
Alcohol Clin Exp Res. 2014 Jan;38(1):235-40. doi: 10.1111/acer.12217. Epub 2013 Aug 1.
The magnitude of risk of injury from drinking, based on emergency department (ED) studies, has been found to vary considerably across studies, and the impact of study design on this variation is unknown.
Patients were interviewed regarding drinking within 6 hours prior to the injury or illness event, drinking during the same time the previous week, and usual drinking during the last 30 days. Risk estimates were derived from case-control analysis and from both pair-matched and usual frequency case-crossover analysis.
The odds ratio (OR) based on case-control (2.7; 1.9 to 3.8) was larger than that based on pair-matched case-crossover analysis (1.6; 1.0 to 2.6). The control-crossover estimate suggested the case-crossover estimate was an underestimate of risk, and when this adjustment was applied to the case-crossover estimate, risk of injury increased (OR = 3.2; 1.7 to 6.0). Adjusted case-crossover estimates compared with unadjusted showed the largest proportional increase at 7 or more drinks prior to injury (OR = 7.1; 2.2 to 22.9). The case-crossover estimate based on usual frequency of drinking was substantially larger (OR = 10.7; 8.0 to 14.3) than that based on case-control or pair-matched case-crossover analysis, but less than either when adjusted based on control-crossover usual frequency analysis (OR = 2.2; 1.5 to 3.3).
The data suggest that while risk of injury based on case-control analysis may be biased, control data are important in providing adjustments derived from control-crossover analysis to case-crossover estimates, and are most important at higher levels of consumption prior to the event.
根据急诊科 (ED) 研究，因饮酒导致受伤的风险幅度在不同研究中差异很大，而研究设计对这种变化的影响尚不清楚。
对患者进行了有关在受伤或患病事件前 6 小时内饮酒、前一周同一时间饮酒以及过去 30 天内通常饮酒的采访。风险估计值来自病例对照分析以及配对匹配和通常频率病例交叉分析。
基于病例对照（2.7；1.9 至 3.8）的比值比（OR）大于基于配对匹配病例交叉分析（1.6；1.0 至 2.6）。对照交叉估计表明病例交叉估计是风险的低估，如果将此调整应用于病例交叉估计，则受伤风险增加（OR = 3.2；1.7 至 6.0）。与未调整相比，调整后的病例交叉估计显示在受伤前 7 次或更多次饮酒时增加的比例最大（OR = 7.1；2.2 至 22.9）。基于通常饮酒频率的病例交叉估计明显大于基于病例对照或配对匹配病例交叉分析的估计（OR = 10.7；8.0 至 14.3），但低于基于对照交叉通常频率分析调整后的估计（OR = 2.2；1.5 至 3.3）。
数据表明，虽然基于病例对照分析的受伤风险可能存在偏差，但对照数据对于从对照交叉分析中提供调整对病例交叉估计很重要，并且在事件发生前更高的消费水平时最为重要。
