Article de Périodique
Relative risk of injury from acute alcohol consumption: modeling the dose-response relationship in emergency department data from 18 countries (2015)
Auteur(s) :
CHERPITEL, C. J. ;
YE, Y. ;
BOND, J. ;
BORGES, G. ;
MONTEIRO, M.
Année :
2015
Page(s) :
279-288
Langue(s) :
Anglais
Refs biblio. :
38
Domaine :
Alcool / Alcohol
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus mots-clés
ALCOOL
;
URGENCE
;
DOSE-REPONSE
;
TYPE D'USAGE
;
FACTEUR DE RISQUE
;
ACCIDENT
;
TRAUMATISME
;
MODELE STATISTIQUE
Thésaurus géographique
INTERNATIONAL
Résumé :
Aims: To update and extend analysis of the dose-response relationship of injury and drinking by demographic and injury subgroups and country-level drinking pattern, and examine the validity and efficiency of the fractional polynomial approach to modeling this relationship.
Design: Pair-matched case-cross-over analysis of drinking prior to injury, using categorical step-function and fractional polynomial analysis.
Setting: Thirty-seven emergency departments (EDs) across 18 countries.
Participants: A total of 13 119 injured drinkers arriving at the ED within 6 hours of the event.
Measurements: The dose-response relationship was analyzed by gender, age, cause of injury (traffic, violence, fall, other) and country detrimental drinking pattern (DDP).
Findings: Estimated risks were similar between the two analytical methods, with injury risk doubling at one drink [odds ratio (OR) = 2.3-2.7] and peaking at about 30 drinks. Although risk was similar for males and females up to three drinks (OR = 4.6), it appeared to increase more rapidly for females and was significantly higher starting from 20 drinks [female OR = 28.6; confidence interval (CI) = 16.8, 48.9; male OR = 12.8; CI = 10.1, 16.3]. No significant differences were found across age groups. Risk was significantly higher for violence-related injury than for other causes across the volume range. Risk was also higher at all volumes for DDP-3 compared with DDP-2 countries.
Conclusions: There is an increasing risk relationship between alcohol and injury but risk is not uniform across gender, cause of injury or country drinking pattern. The fractional polynomial approach is a valid and efficient approach for modeling the alcohol injury risk relationship.
Design: Pair-matched case-cross-over analysis of drinking prior to injury, using categorical step-function and fractional polynomial analysis.
Setting: Thirty-seven emergency departments (EDs) across 18 countries.
Participants: A total of 13 119 injured drinkers arriving at the ED within 6 hours of the event.
Measurements: The dose-response relationship was analyzed by gender, age, cause of injury (traffic, violence, fall, other) and country detrimental drinking pattern (DDP).
Findings: Estimated risks were similar between the two analytical methods, with injury risk doubling at one drink [odds ratio (OR) = 2.3-2.7] and peaking at about 30 drinks. Although risk was similar for males and females up to three drinks (OR = 4.6), it appeared to increase more rapidly for females and was significantly higher starting from 20 drinks [female OR = 28.6; confidence interval (CI) = 16.8, 48.9; male OR = 12.8; CI = 10.1, 16.3]. No significant differences were found across age groups. Risk was significantly higher for violence-related injury than for other causes across the volume range. Risk was also higher at all volumes for DDP-3 compared with DDP-2 countries.
Conclusions: There is an increasing risk relationship between alcohol and injury but risk is not uniform across gender, cause of injury or country drinking pattern. The fractional polynomial approach is a valid and efficient approach for modeling the alcohol injury risk relationship.
Affiliation :
Statistical and Data Services Department, Alcohol Research Group, Emeryville, CA, USA
Cote :
Abonnement