Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs
Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs
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DOI：
10.1016/j.drugalcdep.2016.02.024
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发表时间：
2016-05-01
影响因子：
4.2
通讯作者：
Hayashi, Kanna
中科院分区：
文献类型：
--
作者：
Caudarella, Alexander;Dong, Huiru;Hayashi, Kanna
目的：为了研究非致命性过量和随后的致命overtox.Methods的风险之间的关系：我们评估了过量死亡的危险因素之间的两个前瞻性队列的人谁注射毒品（PWID）在温哥华，加拿大。扩展的考克斯回归被用来检查，如果报告的非致命性过量与致命性过量的时间，同时调整其他行为，社会和结构confersies.Results：1996年5月至2011年12月，2317人进行了随访，中位数为60.8个月。总共确定了134例致死性药物过量死亡，发生率密度为8.94（95%置信区间[CI]：7.55-10.59）例死亡/1000人-年。在研究期间，有1795份非致死性药物过量报告。在多变量模型中，近期非致死性药物过量与至药物过量死亡时间独立相关（校正风险比[AHR] = 1.95; 95% CI：1.17-3.27）。以及，有一个剂量反应效应，增加累积报告的非致命性药物过量对随后的致命overdose.Conclusion：报告最近的非致命性药物过量与随后的过量死亡率的剂量反应关系。这些研究结果表明，报告最近非致命性过量的个人应参与强化过量预防干预措施。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Objectives: To examine the relationship between non-fatal overdose and risk of subsequent fatal overdose.Methods: We assessed risk factors for overdose death among two prospective cohorts of persons who inject drugs (PWID) in Vancouver, Canada. Extended Cox regression was used to examine if reports of non-fatal overdose were associated with the time to fatal overdose while adjusting for other behavioral, social and structural confounders.Results: Between May, 1996 and December, 2011, 2317 individuals were followed for a median of 60.8 months. In total, 134 fatal overdose deaths were identified for an incidence density of 8.94 (95% confidence interval [CI]: 7.55-10.59) deaths per 1000 person-years. During the study period there were 1795 reports of non-fatal overdose. In a multivariate model, recent non-fatal overdose was independently associated with the time to overdose mortality (adjusted hazard ratio [AHR] = 1.95; 95% CI: 1.17-3.27). As well, there was a dose response effect of increasing cumulative reports of non-fatal overdose on subsequent fatal overdose.Conclusion: Reports of recent non-fatal overdose were independently associated with subsequent overdose mortality in a dose-response relationship. These findings suggest that individuals reporting recent non-fatal overdose should be engaged with intensive overdose prevention interventions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.