Mortality risk factors and excess mortality in a cohort of cocaine users admitted to drug treatment in Spain
Mortality risk factors and excess mortality in a cohort of cocaine users admitted to drug treatment in Spain
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DOI：
10.1016/j.jsat.2013.07.001
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发表时间：
2014-02-01
影响因子：
3.9
通讯作者：
Teresa Brugal, M.
中科院分区：
文献类型：
--
作者：
de la Fuente, Luis;Molist, Gemma;Teresa Brugal, M.
我们评估了与普通人群相比的死亡率风险因素和超额死亡率，这两个西班牙子队列包括8，825名可卡因和海洛因使用者（CHU）和11，905名15-49岁的可卡因使用者（OCU）。在考克斯回归分析中，海洛因使用（在所有可卡因使用者中）、无定期就业和药物注射（在CHU和OCU中）、每日使用可卡因和既往药物治疗（在CU中）以及2005年之前死亡和海洛因使用>10年（在CHU中）与较高的死亡率明显相关。超额死亡率通过直接标准化死亡率比率进行评估，该比率在CHU中较高（14.3; 95% Cl：12.6-16.2）（5.1; 95%置信区间：43-6.0），且女性高于男性，尤其是OCU（8.6; 95%置信区间：7.5-10.0 vs. 3.5; 95%置信区间：3.3-3.8）;在初级保健单位中，随着年龄的增长，这一比例下降，但在1997-2008年期间总体上没有下降。OCU超额死亡率相当高，没有显示出下降的迹象，这表明需要改进治疗和预防干预措施。(C)2013 Elsevier Inc. All rights reserved.
We assessed mortality risk factors and excess mortality compared to the general population in two Spanish sub-cohorts of 8,825 cocaine and heroin users (CHUs) and 11,905 only cocaine users (OCUs) aged 15-49 admitted to drug treatment. Heroin use (among all cocaine users), no-regular employment and drug injection (among CHUs and OCUs), daily cocaine use and previous drug treatment (among CUs), and death before 2005 and >10 years of heroin use (among CHUs) were clearly associated with higher mortality in Cox regression. Excess mortality was assessed by the directly standardized mortality rate ratio, which was higher in CHUs (14.3; 95% Cl: 12.6-16.2) than CUs (5.1; 95% Cl: 43-6.0) and in women than men, especially among OCUs (8.6; 95% Cl: 7.5-10.0 vs. 3.5; 95% CI: 3.3-3.8); it decreased with age among CHUs, but did not decrease overall during 1997-2008. OCUs excess mortality was considerable and showed no signs of decline, suggesting the need for improved treatment and prevention interventions. (C) 2013 Elsevier Inc. All rights reserved.