Overdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry data
Overdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry data
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DOI：
10.1111/j.1465-3362.2009.00057.x
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发表时间：
2009-07-01
影响因子：
3.8
通讯作者：
Jolley, Damien
中科院分区：
文献类型：
--
作者：
Stoove, Mark A.;Dietze, Paul M.;Jolley, Damien
引言和目的。以往的非致命性过量已被确定为随后非致命性过量的预测因素；然而，很少有研究调查先前的非致命性过量经历与过量死亡率之间的关系。我们调查了注射吸毒者中的过量死亡率，这些人以前曾因非致命的海洛因过量而被救护车接诊。设计与方法。使用回溯性队列设计，我们将澳大利亚墨尔本五年(2000-2005)救护车出勤记录中非致命性海洛因过量病例的数据与国家死亡登记联系起来。结果。4884名因服用非致命性海洛因过量而被救护车救治的人被确认。该队列中发生了164例服药过量死亡，平均每百人年服药过量死亡率为1.2%(95%可信区间为1.03~1.40)。2000年之后，死亡率下降了10倍，而与此同时，人们普遍报道海洛因供应量下降。男性、年龄较大(35岁)、曾多次服用非致命性过量药物与死亡风险增加相关。讨论和结论。作为第一个表明非致命性过量与随后的过量死亡率直接相关的研究，这项研究对预防过量死亡具有重要的意义。这项研究还显示了宏观层面的海洛因市场动态对过量死亡的深刻影响。[Stoove MA，Dietze PM，Jolley D.之前非致命海洛因过量后的过量死亡：救护车出勤和死亡登记数据的记录联系。毒品酒精修订版2009；28：347-352]。
Introduction and Aims. Experiencing previous non-fatal overdoses have been identified as a predictor of subsequent non-fatal overdoses; however, few studies have investigated the association between previous non-fatal overdose experiences and overdose mortality. We examined overdose mortality among injecting drug users who had previously been attended by an ambulance for a non-fatal heroin overdose. Design and Methods. Using a retrospective cohort design, we linked data on non-fatal heroin overdose cases obtained from ambulance attendance records in Melbourne, Australia over a 5-year period (2000-2005) with a national death register. Results. 4884 people who were attended by ambulance for a non-fatal heroin overdose were identified. One hundred and sixty-four overdose deaths occurred among this cohort, with an average overdose mortality rate of 1.20 per 100 person-years (95% CI, 1.03-1.40). Mortality rate decreased 10-fold after 2000 coinciding with widely reported declines in heroin availability. Being male, of older age (> 35 years) and having been attended multiple times for previous non-fatal overdoses were associated with increased mortality risk. Discussion and Conclusions. As the first to show a direct association between non-fatal overdose and subsequent overdose mortality, this study has important implications for the prevention of overdose mortality. This study also shows the profound effect of macro-level heroin market dynamics on overdose mortality. [Stoove MA, Dietze PM, Jolley D. Overdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry data. Drug Alcohol Rev 2009;28:347-352].