A population-based case-crossover and case-control study of alcohol and the risk of injury
A population-based case-crossover and case-control study of alcohol and the risk of injury
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DOI：
10.15288/jsa.2003.64.358
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发表时间：
2003-05-01
期刊：
影响因子：
--
通讯作者：
Smith, GS
中科院分区：
文献类型：
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作者：
Vinson, DC;Maclure, M;Smith, GS
目的：这项研究调查了酒精与急性损伤风险之间的关系，检查了短期（几个小时内饮酒）和长期暴露（过去一个月的危险饮酒和当前的酒精使用障碍）。方法：采用病例交叉、以人群为基础的病例对照研究。病例（N = 2，517; 1，432名男性）是从密苏里州布恩县的所有三个急诊科招募的受伤患者。在病例交叉分析中，将每个病例在受伤前6小时内的饮酒量与他或她在受伤前一天的饮酒量进行比较。通过电话招募社区对照组（N= 1，856; 948名男性），并按年龄、性别、星期几和小时与病例匹配。病例对照分析检查了最近的酒精消费（过去6小时），过去一个月的危险饮酒和过去一年的酒精使用障碍。结果如下：无论是与自身（病例交叉分析）还是与他人（病例对照分析）进行比较，与短期酒精暴露相关的损伤的比值比（OR）相似。在6小时间隔内喝1杯或2杯后，OR分别为1.8（95%置信区间[Cl]：1.3-2.6）和1.5（0.96-2.2）。在两个比较中观察到类似的剂量-反应曲线，在3或4次饮酒后OR分别为6.2和3.7，在5或6次饮酒后OR分别为9.5和13.5。对于上个月的危险饮酒，OR为1.7（95%CI：1.2-2.3）。当前酒精依赖与损伤相关（OR = 1.9; 95%CI：1.5-2.6），但酒精滥用与损伤无关（OR = 0.9; 95%CI：0.8-1.1）。结论：酒精对伤害风险的影响与急性暴露的关系比与长期暴露的关系更密切。即使在低消费水平，风险也很大。
Objective: This study investigated the relationship between alcohol and the risk of acute injury, examining both short-term (drinking over a few hours) and long-term exposures (past-month hazardous drinking and current alcohol use disorders). Method: The study was a case-crossover and population-based case-control study. Cases (N = 2,517; 1,432 men) were injured patients recruited from all three emergency departments in Boone County, Missouri. Each case's alcohol consumption in the 6 hours prior to injury was compared to his or her consumption the day before in a case-crossover analysis. Community controls (N= 1,856; 948 men) were recruited by telephone and matched to cases by age, gender, day of week and hour. Case-control analyses examined recent alcohol consumption (past 6 hours), past-month hazardous drinking and past-year alcohol use disorders. Results: The odds ratios (ORs) for injury associated with short-term alcohol exposure were similar, whether cases were compared with themselves (case-crossover analyses) or with others (case-control analyses). After I or 2 drinks in a 6-hour interval, the ORs were 1.8 (95% confidence interval [Cl]: 1.3-2.6) and 1.5 (0.96-2.2), respectively. Similar dose-response curves were seen in the two comparisons, with ORs of 6.2 and 3.7, respectively, after 3 or 4 drinks and 9.5 and 13.5 after 5 or 6 drinks. For past-month hazardous drinking, the OR was 1.7 (95% CI: 1.2-2.3). Current alcohol dependence was associated with injury (OR = 1.9; 95% CI: 1.5-2.6), but alcohol abuse was not (OR = 0.9; 95% CI: 0.8-1.1). Conclusions: Alcohol's effect on injury risk is related more strongly to acute exposure than to measures of long-term exposure. The risk is significant even at low levels of consumption.