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Treffer: Mortality Risk in Alcoholic Patients in Northern Italy: Comorbidity and Treatment Retention Effects in a 30-Year Follow-Up Study.

Title:
Mortality Risk in Alcoholic Patients in Northern Italy: Comorbidity and Treatment Retention Effects in a 30-Year Follow-Up Study.
Authors:
Morandi G; Observatory on Pathological Dependences, Modena Local Health Unit, Viale Vittorio Veneto 9, 41100 Modena, Italy., Periche Tomas E; Natbrainlab, Department of Forensics and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IOPPN), King's College London, London, UK pericheve@yahoo.co.uk., Pirani M; Southampton Statistical Sciences Research Institute, University of Southampton, Highfield SO17 1BJ, UK.
Source:
Alcohol and alcoholism (Oxford, Oxfordshire) [Alcohol Alcohol] 2016 Jan; Vol. 51 (1), pp. 63-70. Date of Electronic Publication: 2015 Jun 03.
Publication Type:
Journal Article; Research Support, Non-U.S. Gov't
Language:
English
Journal Info:
Publisher: Oxford University Press Country of Publication: England NLM ID: 8310684 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-3502 (Electronic) Linking ISSN: 07350414 NLM ISO Abbreviation: Alcohol Alcohol Subsets: MEDLINE
Imprint Name(s):
Publication: <2003- > : Oxford : Oxford University Press
Original Publication: Oxford ; New York : Pergamon Press, c1983-
MeSH Terms:
Alcoholism/*mortality , Cardiovascular Diseases/*mortality , Digestive System Diseases/*mortality , Infections/*mortality , Mental Disorders/*epidemiology , Neoplasms/*mortality , Respiratory Tract Diseases/*mortality , Violence/*statistics & numerical data, Adult ; Aged ; Alcoholism/epidemiology ; Alcoholism/rehabilitation ; Cause of Death ; Cohort Studies ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Retrospective Studies ; Sex Factors ; Time Factors
Entry Date(s):
Date Created: 20150605 Date Completed: 20160919 Latest Revision: 20191210
Update Code:
20250114
DOI:
10.1093/alcalc/agv058
PMID:
26041606
Database:
MEDLINE

Weitere Informationen

Aims: To analyse the general and cause-specific mortality over the course of 30 years among subjects treated for alcohol use disorders (AUD) in Northern Italy.
Methods: Cohort of 2499 subjects followed-up for mortality until 31 December 2012. Standardized mortality ratios (SMRs) and 95% confidence intervals (CI) were computed to compare the mortality in the cohort with the general population. Cox regression was used to study the effect of psychiatric disorders, burden of physical comorbidity and retention in treatment on mortality, controlling for socio-demographic factors.
Results: During the follow-up, 435 deaths occurred. Compared with the general population, alcoholics experienced a 5-fold increased mortality (SMR: 5.53; 95% CI: 5.03, 6.07). Significant excess mortality was observed for a range of specific causes: infections, cancers, cardiovascular, respiratory and digestive system diseases as well as violent causes. In multivariate analysis, the hazard of dying was lower for female gender (hazard ratio [HR]: 0.62; 95% CI: 0.46, 0.84) and for increasing length of retention in treatment (HR for third tertile vs first tertile: 0.43; 95% CI: 0.32, 0.57). Burden of physical comorbidity was associated with increased hazard of dying (HR for 3+ comorbidities vs no comorbidities: 4.40; 95% CI: 2.91, 6.66). Psychiatric comorbidity was not associated with mortality.
Conclusions: Despite the harmful effect of AUD, retention in treatment represented a protective factor against death, suggesting that strategies supporting primary medical- and social-care may effectively reduce premature mortality.
(© The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.)