Multi-level analysis of alcohol-related injury among emergency department patients:: a cross-national study
Multi-level analysis of alcohol-related injury among emergency department patients:: a cross-national study
复制标题
DOI：
10.1111/j.1360-0443.2005.01257.x
复制
发表时间：
2005-12-01
期刊：
影响因子：
6
通讯作者：
Hao, W
中科院分区：
文献类型：
--
作者：
Cherpitel, CJ;Ye, Y;Hao, W
目的 本分析的目的是检查急诊科 (ED) 研究中酒精相关伤害的平均发生率和变异、经常饮酒对酒精相关伤害可能性的影响、酒精相关伤害发生率的交叉研究变异是否可以通过研究间的日常消费差异来解释，以及在控制了研究间的日常消费差异后，社会文化背景变量是否有助于解释交叉研究差异。设计数据合并自急诊室协作酒精分析项目(ERCAAP) 和世界卫生组织关于酒精和伤害的合作研究，共同代表了 16 个国家的 28 项研究，包括受伤后 6 小时内到达急诊室的 8423 名（饮酒）伤害患者。酒精相关损伤分别基于血液酒精浓度 (BAC) 阳性和受伤前 6 小时内自我报告的饮酒情况。使用多水平设计和分层广义线性模型进行分析，其中患者嵌套在研究中。结果 BAC 阳性和自我报告的酒精相关损伤的总体患病率分别为 24% 和 29%。在患者层面，过去 12 个月内对数转换的饮酒量是酒精相关损伤的重要预测因子。在研究水平上，观察到酒精相关损伤发生率存在显着差异；总体平均消费量较高的研究报告称，与酒精相关的伤害发生率较高。当饮酒量受到控制时，有害饮酒模式较高且驾驶时醉酒法律水平较高的社会更有可能出现酒精相关伤害发生率增加的情况。结论 酒精相关伤害因急诊室和国家而异。虽然它与个人通常的饮酒量有关，但它也受到许多社会饮酒特征的影响，包括总消费量、整体饮酒模式以及控制饮酒和相关危害的立法政策。
Aim The aim of this analysis was to examine the average rate and variation of alcohol-related injury across emergency department (ED) studies, the effect of usual drinking on likelihood of alcohol-related injury, whether cross-study variation in rate of alcohol-related injury can be explained by between-study difference in usual consumption and whether social-cultural contextual variables help explain cross-study variations, after between-study difference in usual consumption has been controlled.Design Data were merged from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the WHO Collaborative Study on Alcohol and Injuries, together representing 28 studies in 16 countries, and include 8423 (drinking) injury patients who arrived in the ED within 6 hours after injury. Alcohol-related injury was based, separately, on a positive blood alcohol concentration (BAC) and self-reported drinking within 6 hours prior to injury. A multi-level design and hierarchical generalized linear models were used for analysis in which patients were nested within studies.Findings Overall prevalence of alcohol-related injury was 24% and 29% for positive BAC and self-report, respectively. At the patient level, log-transformed alcohol consumption in the last 12 months was a significant predictor of alcohol-related injury. At the study level significant variation in rates of alcohol-related injury was observed; studies with higher overall average consumption reported a higher rate of alcohol-related injury. When volume was controlled, societies with higher detrimental drinking pattern and higher legal level for intoxication while driving were more likely to have an increased rate of alcohol-related injury.Conclusion Alcohol-related injury varies across EDs and countries. While it is associated with an individual's usual alcohol consumption, it is also affected by a number of societal drinking characteristics including the aggregate volume of consumption, overall drinking pattern and legislative policies to control drinking and related harms.