Excess Mortality Among HIV-Infected Patients Diagnosed With Substance Use Dependence or Abuse Receiving Care in a Fully Integrated Medical Care Program
Excess Mortality Among HIV-Infected Patients Diagnosed With Substance Use Dependence or Abuse Receiving Care in a Fully Integrated Medical Care Program
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DOI：
10.1111/j.1530-0277.2010.01335.x
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发表时间：
2011-02-01
影响因子：
3.2
通讯作者：
Quesenberry, Charles P., Jr.
中科院分区：
文献类型：
--
作者：
DeLorenze, Gerald N.;Weisner, Constance;Quesenberry, Charles P., Jr.
背景：我们在一个大型私人医疗项目中研究了hiv感染患者的物质使用（SU）障碍与死亡率之间的关系。方法：在回顾性队列设计中，研究了来自大型健康计划（北加州）的hiv感染患者（>= 14岁），以检查11年期间与SU依赖或滥用诊断相关的死亡率。结果：在研究开始或随访期间，9178名hiv感染患者中有2279名（25%）被诊断为SU障碍。诊断分为仅酒精依赖/滥用、仅非法药物或两者兼而有之。死亡原因因SU诊断类别而异。死亡率范围从每1000人年35.5例患有单纯性疾病的患者到17.5例无单纯性疾病的患者。回归结果显示，在调整了SU治疗和混杂因素后，所有类型SU疾病的死亡风险都明显高于未诊断SU的患者（风险比从1.65到1.67不等）。结论：在获得医疗服务并不是一个重要因素的艾滋病毒感染者中，SU依赖/滥用的诊断与较高的死亡率相关。
Background:We examined the association between substance use (SU) disorder and mortality among HIV-infected patients in a large, private medical care program.Methods:In a retrospective cohort design, HIV-infected patients (>= 14 years old) from a large health plan (Northern California) were studied to examine mortality associated with diagnosis of SU dependence or abuse over an 11-year period.Results:At study entry or during follow-up, 2,279 (25%) of 9,178 HIV-infected patients had received a diagnosis of SU disorder. Diagnoses were categorized as alcohol dependence/abuse only, illicit drugs only, or both. Cause of death differed by the category of SU diagnosis. Mortality rates ranged from 35.5 deaths per 1,000 person-years in patients with an SU disorder to 17.5 deaths among patients without an SU disorder. Regression results indicated mortality risk was significantly higher in all categories of SU disorder compared to no SU diagnosis (hazard ratios ranging from 1.65 to 1.67) after adjustment for SU treatment and confounders.Conclusions:A diagnosis of SU dependence/abuse is associated with higher mortality among HIV-infected patients for whom access to medical services is not a significant factor.