Pranke Mariana de Andrade, Coral Gabriela Perdomo
Programa de Pós-Graduação em Medicina: Hepatologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Arq Gastroenterol. 2017 Dec;54(4):338-343. doi: 10.1590/S0004-2803.201700000-40. Epub 2017 Sep 21.
Alcoholism and alcoholic liver disease are both considered worldwide health problems.
The prevalence of alcohol dependence, the associated risk factors and the concordance between the prevalence found and the data collected during the medical visit were evaluated.
A prospective study evaluating gastroenterology outpatients at a public tertiary hospital was conducted. Two specific questionnaires to assess alcohol dependence were applied: Cut down, Annoyed by criticism, Guilty, Eye-opener (CAGE) and The Alcohol Use Disorder Identification Test (AUDIT). Data on comorbidities, clinical diagnosis and assessment of alcohol consumption by the attending physician were collected through medical records.
One hundred and seventy eight patients were interviewed, of which 119 (66.9%) were women and 59 (33.1%) were men, with mean age of 57 years. Thirty-three (18.5%) of the 178 patients were considered alcohol-dependent by the CAGE questionnaire. Thirteen (7.3%) patients scored 8 points or more on the AUDIT questionnaire. The agreement (kappa) between these questionnaires was 0.37 (P<0.001). The most consumed drink was beer. The median daily consumption of dependent patients was 64 g. None of the patients were undergoing treatment in a specific treatment center, and 14/33 (42.4%) patients considered themselves alcoholics. Only in 17/33 (51.5%) there was information about alcoholism in their respective medical records. In the bivariate analysis, male gender (P<0.001), onset of alcohol consumption before the age of 15 (P=0.003), daily alcohol consumption in the last 12 months (P<0.001) and smoking (P<0.001) were identified as risk factors. After multivariate analysis, only male gender (P=0.009) and smoking (P=0.001) were associated with alcoholism.
The present study demonstrated a high prevalence of alcohol dependence in the gastroenterology outpatient clinic, being predominantly associated with male gender and smoking. It is worth noting that approximately half of the dependents were not identified as such in the medical appointment, evidencing the importance of the diagnostic approach in the alcoholic outpatient.
酗酒和酒精性肝病在全球范围内均被视为健康问题。
评估酒精依赖的患病率、相关危险因素以及所发现的患病率与就诊期间收集的数据之间的一致性。
对一家公立三级医院的胃肠病门诊患者进行了一项前瞻性研究。应用了两份评估酒精依赖的特定问卷：戒酒、因批评而烦恼、内疚、晨饮（CAGE）问卷和酒精使用障碍识别测试（AUDIT）。通过病历收集合并症、临床诊断以及主治医生对酒精消费的评估数据。
共访谈了178名患者，其中119名（6�.9%）为女性，59名（33.1%）为男性，平均年龄为57岁。CAGE问卷显示，178名患者中有33名（18.5%）被认为存在酒精依赖。13名（7.3%）患者在AUDIT问卷上的得分达到8分或更高。这些问卷之间的一致性（kappa值）为0.37（P<0.001）。最常饮用的饮品是啤酒。依赖患者的日均饮酒量中位数为64克。没有患者在特定治疗中心接受治疗，14/33（42.ㄥ%）的患者认为自己是酗酒者。在他们各自的病历中，只有17/33（51.5%）有关于酗酒的信息。在双变量分析中，男性（P<0.001）、15岁之前开始饮酒（P=0.003）、过去12个月的日均饮酒量（P<0.001）和吸烟（P<0.001）被确定为危险因素。多变量分析后，只有男性（P=0.009）和吸烟（P=0.001）与酗酒相关。
本研究表明，胃肠病门诊中酒精依赖的患病率较高，主要与男性和吸烟有关。值得注意的是，约一半的依赖者在就诊时未被识别出来，这证明了在酗酒门诊进行诊断方法的重要性。
