Impact of alcohol use disorder on mortality: special attention in Injury related mortality
METHODS: We carried out a longitudinal study of retrospective cohort with 7,109 patients aged 18-64 years (76.5% men), who started treatment for AUD according to DSM-IV criteria between 1997 and 2007. Deaths were monitored until the end of 2008 using the National Mortality Register. Person-years of follow-up and crude mortality rates (CMR) with confidence intervals (CI) at 95% for each variable were calculated. The variables were analyzed stratifying by sex and age. Standardized mortality ratios (SMR) by age and gender and population attributable risks (PAR) by age group were estimated.
RESULTS: There were 557 deaths (83% were men) and 114 of them was for external causes. The CMR for external causes were 2.7 [95%CI:2.2-3.2) per 1000 py, with no significant differences in both genders, except in younger men. The most frequent causes were unintentional injuries. Among these, the traffic injuries signified the 23% and poisonings the 21%. The intentional injuries represented the 43% of external cause, corresponding 92% to suicides and 8.2% to homicides. The total excess mortality was 8 times higher than in the general population, especially in the group aged 25-34 years old (SMR: 11.2 [95%CI:7.8-16.0] in men and 24 [95%CI:11.5-50.4] in women). Significant differences by gender were found in all the variables analyzed. The AUD was estimated to cause the 3.3% of the total annual deaths. This percentage was higher in the groups aged 25-34 years (PAR: 19.4% [95%CI:19.2-19.6]) and 18-24 years (PAR: 11.1% [95%CI:10.7-11.4]).
CONCLUSIONS: Women and young men with an AUD have a higher risk of early mortality, especially by suicide, alcohol intoxication and traffic injuries. Early detection of AUD and prevention programs should be improved.