Brugal M T, Villalbí J R, Torralba L, Valverde J L, Tortosa M T
Institut Municipal de la Salut, Ajuntament de Barcelona.
Med Clin (Barc). 1995 Oct 14;105(12):441-5.
Mortality caused by acute adverse drug reactions (AADR) increased in Spain over the eighties and has become one of the major causes of death for youth. This paper presents the results of a study in the city of Barcelona during the 1983-92 decade; based in the city drug information system.
The study includes all deaths caused by AADR autopsied in the Forensic Institute between 1983 and 1992. Mortality of city residents is analyzed by cohort, grouping data in two-years and adjusting Poisson regression to mortality rates by age group, birth cohort and period of study.
During this period a sharp increase in AADR mortality is seen, as there were 19 deaths in the city in 1983 and 160 in 1992. The increase concentrates in the years 1987-89. Although previously the increasing mortality of drug users was related by some observers with the progressive deterioration of their health status, linked to their increasing age and to the cumulative effects of years of substance dependence, the mortality analysis points to a clear period effect, resulting in an increased mortality across all age groups, for cohorts born after 1960.
These results point to changes in the illegal drug market in the city or in the patterns of abuse as most likely causes for the increase. The results also suggest that since 1989 there is a stabilization in mortality due to AADR, which deserves further study.
20世纪80年代，西班牙急性药物不良反应（AADR）导致的死亡率有所上升，已成为年轻人主要死因之一。本文介绍了一项基于巴塞罗那市药物信息系统，于1983 - 1992年开展的研究结果。
该研究纳入了1983年至1992年间在法医研究所进行尸检的所有由AADR导致的死亡案例。通过队列分析城市居民的死亡率，将数据按两年分组，并对年龄组、出生队列和研究时期的死亡率进行泊松回归调整。
在此期间，AADR死亡率急剧上升，1983年该市有19例死亡，1992年则有160例。增长集中在1987 - 1989年。尽管此前一些观察家认为吸毒者死亡率上升与他们健康状况的逐渐恶化有关，这与他们年龄的增长以及多年药物依赖的累积影响有关，但死亡率分析表明存在明显的时期效应，导致1960年后出生的所有年龄组死亡率均上升。
这些结果表明，该市非法药物市场的变化或滥用模式很可能是死亡率上升的原因。结果还表明，自1989年以来，AADR导致的死亡率趋于稳定，这值得进一步研究。
