2003 年至 2016 年安大略省因饮酒导致的急诊科就诊率：一项回顾性人群水平研究。
Rates of emergency department visits attributable to alcohol use in Ontario from 2003 to 2016: a retrospective population-level study.
机构信息
School of Epidemiology and Public Health (Myran), Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program (Hsu, Smith), The Ottawa Hospital, Ottawa Hospital Research Institute; ICES uOttawa (Smith); Bruyère Research Institute (Hsu, Tanuseputro); Department of Medicine (Tanuseputro), University of Ottawa, Ottawa, Ont.
出版信息
CMAJ. 2019 Jul 22;191(29):E804-E810. doi: 10.1503/cmaj.181575.
BACKGROUND
Alcohol use causes a large burden on the health of Canadians, and alcohol-related harms appear to be increasing in many high-income countries. We sought to analyze changes in emergency department visits attributable to alcohol use, by sex, age and neighbourhood income over time.
METHODS
All individuals aged 10 to 105 years living in Ontario, Canada, between 2003 and 2016 were included in this study. The primary outcome was age-standardized rates of emergency department visits attributable to alcohol use, defined using diagnostic codes from the Canadian Institute for Health Information Health Indicator "hospitalizations entirely caused by alcohol." We compared rates of these visits using a retrospective population-level design.
RESULTS
Among 15 121 639 individuals, there were 765 346 emergency department visits attributable to alcohol use over the study period. Between 2003 and 2016, the age-standardized rates of these visits increased more in women (86.5%) than in men (53.2%), and the increase in rates of emergency department visits attributable to alcohol use was 4.4 times greater than the increases in the rates of overall emergency department visits. Individuals aged 25-29 years experienced the largest change in the rate of emergency department visits attributable to alcohol use (175%). We found evidence of age-cohort effects, whereby the rate of emergency department visits attributable to alcohol use at age 19 years increased on average by 4.07% (95% confidence interval [CI] 3.71%-4.44%) per year for each cohort born between 1986 and 1999. Individuals in the lowest neighbourhood income quintile had 2.37 (95% CI 2.27-2.49) times the rate of emergency department visits attributable to alcohol use than those in the highest income quintile. This disparity increased slightly over the study period.
INTERPRETATION
Although men and lower-income individuals have the highest burden of emergency department visits attributable to alcohol use, the largest increases in visits have been in women and younger adults. Further research should focus on potential causes of these trends to provide guidance on how to reduce alcohol-related harms.
背景
饮酒给加拿大人的健康带来了沉重负担，而且在许多高收入国家，与酒精相关的危害似乎正在增加。我们试图分析随时间推移，因饮酒而导致的急诊就诊人数变化，分析指标包括性别、年龄和社区收入。
方法
本研究纳入了 2003 年至 2016 年期间居住在加拿大安大略省的所有 10 至 105 岁人群。主要结局是使用加拿大健康信息研究所健康指标“完全由酒精引起的住院治疗”中的诊断代码定义的因饮酒而导致的急诊就诊的年龄标准化率。我们使用回顾性人群水平设计比较了这些就诊率。
结果
在 15121639 人中，研究期间因饮酒而导致的急诊就诊有 765346 次。2003 年至 2016 年期间，女性的就诊率年龄标准化增幅（86.5%）高于男性（53.2%），因饮酒而导致的急诊就诊率增幅是同期整体急诊就诊率增幅的 4.4 倍。25-29 岁人群因饮酒而导致的急诊就诊率变化最大（175%）。我们发现了年龄队列效应的证据，即 19 岁时因饮酒而导致的急诊就诊率平均每年随每批出生于 1986 年至 1999 年的队列增加 4.07%（95%置信区间[CI] 3.71%-4.44%）。收入最低的五分之一社区的个体因饮酒而导致的急诊就诊率是收入最高的五分之一社区的个体的 2.37 倍（95%CI 2.27-2.49）。这一差距在研究期间略有增加。
结论
尽管男性和低收入个体因饮酒而导致的急诊就诊负担最重，但就诊人数增加最多的是女性和年轻人。进一步的研究应重点关注这些趋势的潜在原因，为如何减少与酒精相关的危害提供指导。
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