Alcohol use disorders and associated chronic disease - a national retrospective cohort study from France

• Published in: BMC public health Vol. 18; no. 1; p. 43
• Main Authors: Schwarzinger, Michaël, Thiébaut, Sophie Pascale, Baillot, Sylvain, Mallet, Vincent, Rehm, Jürgen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21-07-2017; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Aged, 80 and over; Alcohol use; Alcohol use disorders; Alcohol-Related Disorders - mortality; Alcoholism - complications; Alcoholism - mortality; Alcohols; Analysis; Bias; Breast cancer; Burden of disease; Cancer; Cardiac arrhythmia; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - mortality; Care and treatment; Categories; Chronic Disease - mortality; Chronic illnesses; Cohort analysis; Communicable Diseases - mortality; Dementia; Dementia - mortality; Dementia disorders; Digestive system diseases; Digestive System Diseases - mortality; Diseases; Disorders; Drinking of alcoholic beverages; Fatalities; Female; France; France - epidemiology; Gender; Health aspects; Health risk assessment; Health risks; Heart; Hospitalization; Hospitals; Humans; Infectious diseases; Inpatients; Liver; Liver diseases; Liver Diseases - mortality; Male; Middle Aged; Mortality; Mortality, Premature; Neoplasms - mortality; Non-communicable disease; Pancreatitis; Patients; Pneumonia; Rehabilitation; Retrospective Studies; Risk factor; Risk Factors; Sampling methods; Statistical analysis; Tuberculosis; Womens health; Wounds and Injuries - mortality; France; Non-communicable disease; Burden of disease; Mortality; Risk factor; Alcohol use disorders
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-017-4587-y

Evidence on diseases caused by or associated with alcohol use disorders (AUDs) has been based on two meta-analyses including rather dated studies. The objective of this contribution was to estimate the risks of all-cause mortality and alcohol-attributable disease categories depending on a diagnosis of AUDs in a national sample for France.
In a national retrospective cohort study on all inpatient acute and rehabilitation care patients in Metropolitan France 2008-2012 (N = 26,356,361), AUDs and other disease categories were identified from all discharge diagnoses according to standard definitions, and we relied on in-hospital death for mortality (57.4% of all deaths).
704,803 (2.7%) patients identified with AUDs had a threefold higher risk of death (HR = 2.98; 95% CI: 2.96-3.00) and died on average 12.2 years younger (men: 10.4, 95% CI: 10.3-10.5; women: 13.7, 95% CI: 13.6-13.9). AUDs were associated with significantly higher risks of hospital admission for all alcohol-attributable disease categories: digestive diseases, cancers (exception: breast cancer), cardiovascular diseases, dementia, infectious diseases, and injuries. Elevated risks were highest for liver diseases that were associated with about two-third of deaths in patients with AUDs (men: 64.3%; women: 71.1%).
AUDs were associated with marked premature mortality and higher risks of alcohol-attributable disease categories. Our results support the urgent need of measures to reduce the burden of AUDs.