Mortality among people who inject drugs: a systematic review and meta-analysis
Mortality among people who inject drugs: a systematic review and meta-analysis
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DOI：
10.2471/blt.12.108282
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发表时间：
2013-02-01
影响因子：
11.1
通讯作者：
Hickman, Mathew
中科院分区：
文献类型：
--
作者：
Mathers, Bradley M;Degenhardt, Louisa;Hickman, Mathew
目的系统回顾注射毒品人群死亡率的队列研究，研究这一群体的死亡率和死亡原因，并确定参与者和研究水平的变量与较高的死亡风险相关。通过在线灰色文献数据库识别灰色文献。咨询了专家，以获得更多的研究和数据。随机效应荟萃分析进行估计汇总粗死亡率（CMR）和标准化死亡率比（SMRs）。结果67队列的人谁注射毒品被确定，其中14个来自低收入和中等收入国家。汇总CMR为2.35例死亡/100人年（95%置信区间，CI：2.12-2.58）。32个队列报告了SMR;汇总SMR为14.68（95% CI：13.01-16.35）。对遗留集束弹药死亡率的比较和遗留集束弹药死亡率比率的计算显示，低收入和中等收入国家群组、男性和注射人体免疫缺陷病毒（艾滋病毒）阳性药物的人的死亡率较高。在停止治疗期间也较高。药物过量和获得性免疫缺陷综合征（艾滋病）是跨cohols.Conclusion死亡的主要原因相比，一般人群，注射毒品的人有较高的死亡风险，虽然死亡率在不同的设置不同。任何改善这一群体健康结果的综合办法都必须包括努力减少艾滋病毒感染以及其他死亡原因，特别是药物过量。
Objective To systematically review cohort studies of mortality among people who inject drugs, examine mortality rates and causes of death in this group, and identify participant- and study-level variables associated with a higher risk of death.Methods Tailored search strings were used to search EMBASE, Medline and PsycINFO. The grey literature was identified through online grey literature databases. Experts were consulted to obtain additional studies and data. Random effects meta-analyses were performed to estimate pooled crude mortality rates (CMRs) and standardized mortality ratios (SMRs).Findings Sixty-seven cohorts of people who inject drugs were identified, 14 of them from low- and middle-income countries. The pooled CMR was 2.35 deaths per 100 person years (95% confidence interval, CI: 2.12-2.58). SMRs were reported for 32 cohorts; the pooled SMR was 14.68 (95% CI: 13.01-16.35). Comparison of CMRs and the calculation of CMR ratios revealed mortality to be higher in low- and middle-income country cohorts, males and people who injected drugs that were positive for human immunodeficiency virus (HIV). It was also higher during off-treatment periods. Drug overdose and acquired immunodeficiency syndrome (AIDS) were the primary causes of death across cohorts.Conclusion Compared with the general population, people who inject drugs have an elevated risk of death, although mortality rates vary across different settings. Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose.