Seaman S R, Brettle R P, Gore S M
Medical Research Council Biostatistics Unit, Institute of Public Health, Cambridge.
BMJ. 1998 Feb 7;316(7129):426-8. doi: 10.1136/bmj.316.7129.426.
To assess whether injecting drug users have a higher than usual risk of death from overdose in the 2 weeks after release from prison.
Soundex coding of surnames and information on date of birth were used to link entry and release dates from the local prison between 1983 and 1994 with clinical data from Edinburgh City Hospital's cohort of male injecting drug users who are infected with HIV.
Edinburgh City Hospital and Edinburgh Prison.
316/332 male injecting drug users infected with HIV in the City Hospital HIV cohort; 16 were excluded because they were enrolled after developing AIDS or because their precise date of death was not available.
Relative risk of dying from overdose before developing AIDS and relative risk of dying of all causes before developing AIDS during the 2 weeks after release from prison; this was compared with relative risks of death during other time at liberty.
238/316 (75%) injecting drug users served time in the prison between 1983 and 1994. 33 out of 316 injecting drug users who were infected with HIV died before developing AIDS during 517,177 days at risk. 20 of these men died of an overdose; 6 of these deaths occurred within 2 weeks of release during 5903 days at risk. Death rates from overdose before the development of AIDS were 1.02/1000 days during the 2 weeks after release (recently released) and 0.029/1000 days during other times of liberty. The relative risk of death from overdose became 7.7 (1.5 to 39.1) after temporal matching (when the comparison was limited to the first 2 weeks after release v the next 10 weeks). The crude relative risk in an analysis combining stratified prison term and the 2 weeks after release was 4.5 (1.7 to 11.7) for death from overdose. After temporal matching these risks became 1.8 (0.4 to 9.2).
Prisons should evaluate interventions to reduce the risk of death from overdose after release.
评估注射吸毒者出狱后2周内死于过量用药的风险是否高于正常水平。
使用姓氏的语音编码以及出生日期信息，将1983年至1994年期间当地监狱的入狱和出狱日期与爱丁堡市医院感染艾滋病毒的男性注射吸毒者队列的临床数据相联系。
爱丁堡市医院和爱丁堡监狱。
市医院艾滋病毒队列中316/332名感染艾滋病毒的男性注射吸毒者；16人被排除，原因是他们在患艾滋病后入组或无法获得其确切死亡日期。
出狱后2周内患艾滋病前死于过量用药的相对风险以及患艾滋病前死于各种原因的相对风险；并与其他自由时间的死亡相对风险进行比较。
238/316（75%）名注射吸毒者在1983年至1994年期间在监狱服刑。在316名感染艾滋病毒的注射吸毒者中，有33人在517,177天的风险期内患艾滋病前死亡。其中20人死于过量用药；这些死亡中有6例发生在出狱后2周内的5903天风险期内。患艾滋病前过量用药的死亡率在出狱后2周（刚获释）为1.02/1000天，在其他自由时间为0.029/1000天。时间匹配后（当比较限于出狱后的前2周与接下来的10周时），死于过量用药的相对风险变为7.7（1.5至39.1）。在结合分层刑期和出狱后2周的分析中，死于过量用药的粗略相对风险为4.5（1.7至11.7）。时间匹配后，这些风险变为1.8（0.4至9.2）。
监狱应评估干预措施，以降低出狱后死于过量用药的风险。
