A Comparison of Liver Disease Mortality With HIV and Overdose Mortality Among Georgia Prisoners and Releasees: A 2-Decade Cohort Study of Prisoners Incarcerated in 1991
A Comparison of Liver Disease Mortality With HIV and Overdose Mortality Among Georgia Prisoners and Releasees: A 2-Decade Cohort Study of Prisoners Incarcerated in 1991
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DOI：
10.2105/ajph.2014.302546
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发表时间：
2015-05-01
影响因子：
12.7
通讯作者：
Binswanger, Ingrid A.
中科院分区：
文献类型：
--
作者：
Spaulding, Anne C.;Sharma, Akshay;Binswanger, Ingrid A.
目标.我们调查了美国东南部一组囚犯的最终死亡原因是否与以前的囚犯研究不同。我们将格鲁吉亚的23510名囚犯与2010年的死亡登记处进行了匹配，格鲁吉亚是一个海洛因消费水平历史上较低但注射毒品使用量适中的州，他们于1991年6月30日被监禁。主要暴露时间间隔为4年，观察期为20年;主要结局为肝病、HIV和过量的死亡率。虽然在2003年之前，与艾滋病毒有关的死亡率超过了与肝脏有关的死亡率，但肝脏疾病随后超过了艾滋病毒，成为死亡原因。在3863例死亡中，22例（0.6%）发生在出狱后2周内。其中，只有2例是由意外中毒（可能是药物过量）引起的。心血管疾病和癌症是老年人群最常见的死亡原因。我们的研究设计不强调直接死亡，但强调暴露于病毒性肝炎和酒精的长期后遗症。治疗丙型肝炎和实施干预措施来管理酒精使用障碍可能会改善东南部囚犯的生存率。
Objectives. We investigated whether eventual causes of death among a cohort of inmates imprisoned in the southeastern United States differed from those in previous prisoner studies.Methods. We matched 23 510 prisoners in Georgia, a state with historically low levels of heroin consumption but moderate amounts of injection drug use, who were incarcerated on June 30, 1991, to death registries through 2010. Main exposure was 4-year time intervals over 2 decades of observation; main outcome was mortality from liver disease, HIV, and overdose.Results. Although the HIV-related mortality rate exceeded that from liver-related conditions before 2003, liver disease subsequently surpassed HIV as a cause of death. Among 3863 deaths, 22 (0.6%) occurred within 2 weeks after release from prison. Of these, only 2 were caused by accidental poisoning (likely drug overdose). Cardiovascular disease and cancer were the most frequent causes of death in this aging cohort.Conclusions. Our study design deemphasized immediate deaths but highlighted long-term sequelae of exposure to viral hepatitis and alcohol. Treating hepatitis C and implementing interventions to manage alcohol use disorders may improve survival among prisoners in the Southeast.