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Risk of injury from acute alcohol consumption and the influence of confounders.

Abstract

AIM

To quantify the relationship between acute alcohol consumption and risk of injury, in the context of other potential confounding factors (i.e. usual alcohol intake, risk-taking behaviour and substance use-defined as prescription/over-the-counter medication or illicit substances), using three separate measures of alcohol consumption.

DESIGN

A hospital-based, case-control study.

SETTING

The accident and emergency department at a large metropolitan teaching hospital in Queensland, Australia.

PARTICIPANTS

Four hundred and eighty-eight cases were matched to 488 population controls on gender, age group, neighbourhood, day and time of injury.

MEASUREMENTS

Risk factor and injury information was obtained by questionnaire and medical record review.

RESULTS

After controlling for demographic and situational variables (i.e. activity, location and companions at time of injury), consuming any alcohol in the 6 hours prior to time of injury significantly increased risk of injury [odds ratio (OR) = 2.13, 95% confidence interval (CI): 1.3-3.9]. Drinking at levels above low-risk guidelines for short-term health (i.e. drinking > 40 g alcohol per occasion if female, and drinking > 60 g alcohol if male) increased injury risk by a factor of almost 2.5 (OR = 2.41; 95% CI = 1.1-5.2). Finally, drinking beer (OR = 1.86; 95% CI = 0.9-3.9), spirits (OR = 3.05; 95% CI = 1.1-8.2) or a combination of beverages (OR = 3.16; 95% CI = 1.1-8.8) increased risk of injury. When usual alcohol consumption patterns were adjusted for, substantial increases in the alcohol-injury odds ratios were observed for all measures of alcohol. When risk-taking behaviour and substance use were considered, changes in the effect of alcohol on injury risk were observed, for all measures of alcohol. These data support the hypotheses that some confounding exists in the alcohol-injury relationship due to usual drinking patterns, risk-taking and substance use.

CONCLUSIONS

In this study, acute alcohol consumption significantly increased the risk of injury, even when situational and other risk factors were considered. However, the relationship between alcohol and injury appears confounded by usual drinking patterns, risk-taking behaviour and substance use. Therefore, these variables should be considered in any analysis of the alcohol-injury relationship, and also considered when developing public health strategies to reduce alcohol-related injury. Further research is required to elucidate the nature of this relationship, and to identify the effect of risk-taking and substance use on different types of injuries (e.g. mechanism of injury; body region injured) and injury severity. The stability of the models and the consistency of the findings across all measures of alcohol used support claims for the validity of the observed effects.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Violence Research Group, University of Wales College of Medicine, Cardiff, UK. wattk@cardiff.ac.uk

    , ,

    Source

    Addiction (Abingdon, England) 99:10 2004 Oct pg 1262-73

    MeSH

    Adolescent
    Adult
    Age Distribution
    Alcohol Drinking
    Australia
    Epidemiologic Methods
    Female
    Hospitals, Teaching
    Humans
    Male
    Medical History Taking
    Middle Aged
    Risk-Taking
    Sex Distribution
    Substance-Related Disorders
    Surveys and Questionnaires
    Wounds and Injuries

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15369564

    Citation

    Watt, Kerrianne, et al. "Risk of Injury From Acute Alcohol Consumption and the Influence of Confounders." Addiction (Abingdon, England), vol. 99, no. 10, 2004, pp. 1262-73.
    Watt K, Purdie DM, Roche AM, et al. Risk of injury from acute alcohol consumption and the influence of confounders. Addiction. 2004;99(10):1262-73.
    Watt, K., Purdie, D. M., Roche, A. M., & McClure, R. J. (2004). Risk of injury from acute alcohol consumption and the influence of confounders. Addiction (Abingdon, England), 99(10), pp. 1262-73.
    Watt K, et al. Risk of Injury From Acute Alcohol Consumption and the Influence of Confounders. Addiction. 2004;99(10):1262-73. PubMed PMID: 15369564.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of injury from acute alcohol consumption and the influence of confounders. AU - Watt,Kerrianne, AU - Purdie,David M, AU - Roche,Anne M, AU - McClure,Roderick J, PY - 2004/9/17/pubmed PY - 2005/4/9/medline PY - 2004/9/17/entrez SP - 1262 EP - 73 JF - Addiction (Abingdon, England) JO - Addiction VL - 99 IS - 10 N2 - AIM: To quantify the relationship between acute alcohol consumption and risk of injury, in the context of other potential confounding factors (i.e. usual alcohol intake, risk-taking behaviour and substance use-defined as prescription/over-the-counter medication or illicit substances), using three separate measures of alcohol consumption. DESIGN: A hospital-based, case-control study. SETTING: The accident and emergency department at a large metropolitan teaching hospital in Queensland, Australia. PARTICIPANTS: Four hundred and eighty-eight cases were matched to 488 population controls on gender, age group, neighbourhood, day and time of injury. MEASUREMENTS: Risk factor and injury information was obtained by questionnaire and medical record review. RESULTS: After controlling for demographic and situational variables (i.e. activity, location and companions at time of injury), consuming any alcohol in the 6 hours prior to time of injury significantly increased risk of injury [odds ratio (OR) = 2.13, 95% confidence interval (CI): 1.3-3.9]. Drinking at levels above low-risk guidelines for short-term health (i.e. drinking > 40 g alcohol per occasion if female, and drinking > 60 g alcohol if male) increased injury risk by a factor of almost 2.5 (OR = 2.41; 95% CI = 1.1-5.2). Finally, drinking beer (OR = 1.86; 95% CI = 0.9-3.9), spirits (OR = 3.05; 95% CI = 1.1-8.2) or a combination of beverages (OR = 3.16; 95% CI = 1.1-8.8) increased risk of injury. When usual alcohol consumption patterns were adjusted for, substantial increases in the alcohol-injury odds ratios were observed for all measures of alcohol. When risk-taking behaviour and substance use were considered, changes in the effect of alcohol on injury risk were observed, for all measures of alcohol. These data support the hypotheses that some confounding exists in the alcohol-injury relationship due to usual drinking patterns, risk-taking and substance use. CONCLUSIONS: In this study, acute alcohol consumption significantly increased the risk of injury, even when situational and other risk factors were considered. However, the relationship between alcohol and injury appears confounded by usual drinking patterns, risk-taking behaviour and substance use. Therefore, these variables should be considered in any analysis of the alcohol-injury relationship, and also considered when developing public health strategies to reduce alcohol-related injury. Further research is required to elucidate the nature of this relationship, and to identify the effect of risk-taking and substance use on different types of injuries (e.g. mechanism of injury; body region injured) and injury severity. The stability of the models and the consistency of the findings across all measures of alcohol used support claims for the validity of the observed effects. SN - 0965-2140 UR - https://www.unboundmedicine.com/medline/citation/15369564/Risk_of_injury_from_acute_alcohol_consumption_and_the_influence_of_confounders_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0965-2140&date=2004&volume=99&issue=10&spage=1262 DB - PRIME DP - Unbound Medicine ER -