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Affiliation
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Alcohol Research Group, 6475 Christie Avenue Suite 400, Emeryville, CA 94608, USA. |
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Abstract
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AIMS: To update and extend analysis of the dose-response relationship of injury and drinking by demographic and injury subgroups and country-level drinking pattern, and examine the validity and efficiency of the fractional polynomial approach to modeling this relationship.
DESIGN: Pair-matched case-crossover analysis of drinking prior to injury, using categorical step-function and fractional polynomial analysis. SETTING: 37 emergency departments (EDs) across 18 countries. PARTICIPANTS: 13,119 injured drinkers arriving at the ED within six hours of the event. MEASUREMENTS: The dose-response relationship was analyzed by gender, age, cause of injury (traffic, violence, fall, other), and country detrimental drinking pattern (DDP).
FINDINGS: Estimated risks were similar between the two analytic methods, with injury risk doubling at one drink (OR = 2.3 - 2.7) and peaking at about 30 drinks. Although risk was similar for males and females up to three drinks (OR = 4.6), it appeared to increase more rapidly for females and was significantly higher starting from 20 drinks (female OR = 28.6; CI (16.8, 48.9); male OR = 12.8; CI (10.1, 16.3)). No significant differences were found across age groups. Risk was significantly higher for violence-related injury than for other causes across the volume range. Risk was also higher at all volumes for DDP-3 compared with DDP-2 countries.
CONCLUSIONS: There is an increasing risk relationship between alcohol and injury, but risk is not uniform across gender, cause of injury, or country drinking pattern. The fractional polynomial approach is a valid and efficient approach for modeling the alcohol-injury risk relationship.
Language: en |