Diminishing Trend in Alcohol Poisoning Mortality in Estonia: Reality or Coding Peculiarity?
Diminishing Trend in Alcohol Poisoning Mortality in Estonia: Reality or Coding Peculiarity?
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DOI：
10.1093/alcalc/agr046
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发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Rahu, Mati
中科院分区：
文献类型：
--
作者：
Rahu, Kaja;Palo, Ene;Rahu, Mati
目的：研究编码实践的变化是否可以降低爱沙尼亚的酒精中毒死亡率。研究方法：1983-2009年的个人死亡记录（死亡年龄25-64岁）用于计算年龄标准化死亡率的3年移动平均数。从2000年起，酒精所致精神障碍的死亡率急剧上升，与此同时，酒精中毒死亡率显著下降。我们计算了2000-2009年的预期酒精中毒死亡率，假设酒精中毒和酒精所致精神障碍的死亡率比率保持稳定。结果：酒精中毒死亡率波动较大，1988年最低，1994 ~ 1995年最高。2000年开始急剧下降。预计酒精中毒死亡率自2000年起继续上升，2006-2009年略有下降。截至1999年，酒精所致精神障碍的死亡率与酒精中毒率遵循相同的曲线，男女的酒精中毒率都低约10倍。从2000年起，酒精所致精神障碍的死亡率迅速上升，2006年超过了酒精中毒死亡率。结论：这项研究表明，在爱沙尼亚死亡原因登记处，酒精中毒和酒精所致精神障碍作为潜在死亡原因的编码存在明显的错误分类。
Aims: To examine whether the changes in coding practice could reduce alcohol poisoning mortality rates in Estonia. Methods: Individual death records in 1983-2009 (age at death 25-64) were used to calculate the 3-year moving averages of age-standardized mortality rates. From 2000 onwards, there was a sharp increase in mortality from mental disorders due to alcohol, and at the same time a remarkable decrease in alcohol poisoning mortality. We calculated expected alcohol poisoning mortality rates for 2000-2009, assuming that mortality rate ratio of alcohol poisoning and mental disorders due to alcohol remained stable. Results: Alcohol poisoning mortality rates fluctuated considerably, being the lowest in 1988 and the highest in 1994-1995. A sharp decline started in 2000. Expected alcohol poisoning mortality rates continued their growth from 2000 onwards with a small decrease in 2006-2009. Mortality rates of mental disorders due to alcohol followed the same curve as alcohol poisoning rates up to 1999, being roughly 10 times lower than alcohol poisoning rates in both genders. From 2000 onwards, mortality from mental disorders due to alcohol increased rapidly, exceeding alcohol poisoning mortality in 2006. Conclusion: This study demonstrates an obvious misclassification in coding of alcohol poisoning and mental disorders due to alcohol as underlying causes of death in the Estonian Causes of Death Registry.