酒精使用障碍患者肝硬化诊断时间和诊断后存活率的健康差异：一项回顾性队列研究。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Alcohol Pub Date : 2024-02-24 DOI:10.1016/j.alcohol.2024.02.005

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引用次数: 0

摘要

目标：本研究调查了种族、性别和民族对酒精使用障碍患者从确诊到肝硬化的进展及后续生存期的影响，重点是识别健康结果中的潜在差异：我们采用符合 STROBE 标准的回顾性队列设计，利用加州大学健康数据仓库分析了 2000 年 1 月至 2022 年 12 月期间确诊为酒精使用障碍的患者数据。我们使用 Kaplan-Meier 方法估计了生存函数，并使用双变量和多变量 Cox 比例危险模型评估了人口统计学关联：结果：分析结果表明，西班牙裔与酒精相关性肝硬化确诊时间加快（酒精使用障碍确诊后）和肝硬化确诊后死亡率加快之间存在明显关联。前者仅在双变量分析中表现明显，但后者在多变量分析中持续存在。性别与这些结果的发生时间没有明显的相关性，但多种族身份认同是一个保护因素：结论：该研究揭示了肝硬化进展和结局中存在的严重健康差异，尤其是西班牙裔和非西班牙裔患者之间的差异。这些发现强调，迫切需要有针对性的医疗干预措施和政策来解决这些差异。未来的研究应深入探讨影响这些结果的多方面因素，从而促进针对酒精使用障碍及其严重并发症制定更加细致有效的预防和治疗策略。

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Health disparities in time to diagnosis and survival post-diagnosis of cirrhosis in individuals with alcohol use disorder: A retrospective cohort study

Objective

This study investigates the impact of race, gender, and ethnicity on the progression from diagnosis to cirrhosis and subsequent survival in patients with alcohol use disorder, with a specific focus on identifying potential disparities in health outcomes.

Method

Employing a STROBE-compliant, retrospective cohort design, we analyzed data from patients diagnosed with alcohol use disorder from January 2000 to December 2022, using the University of California Health Data Warehouse. We estimated survival functions using the Kaplan–Meier method and assessed demographic associations using both bivariate and multivariate Cox proportional hazards models.

Results

The analysis highlighted a significant association between Hispanic ethnicity and an accelerated timeline for both the diagnosis of alcohol-related cirrhosis following diagnosis of alcohol use disorder and mortality post-cirrhosis diagnosis. The former was evident only in bivariate analysis, but the latter association persisted in multivariate analysis. Gender did not demonstrate a significant correlation with the time to these outcomes, though multiracial identification emerged as a protective factor.

Conclusions

The study reveals critical health disparities in the progression and outcomes of cirrhosis, particularly between Hispanic and non-Hispanic patients. These findings underscore the urgent need for targeted healthcare interventions and policies that address these disparities. Future research should delve deeper into the multifaceted factors influencing these outcomes, facilitating the development of more nuanced and effective prevention and treatment strategies for alcohol use disorder and its severe complications.

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来源期刊

Alcohol 医学-毒理学

CiteScore

4.60

自引率

4.30%

发文量

审稿时长

15.6 weeks

期刊介绍： Alcohol is an international, peer-reviewed journal that is devoted to publishing multi-disciplinary biomedical research on all aspects of the actions or effects of alcohol on the nervous system or on other organ systems. Emphasis is given to studies into the causes and consequences of alcohol abuse and alcoholism, and biomedical aspects of diagnosis, etiology, treatment or prevention of alcohol-related health effects. Intended for both research scientists and practicing clinicians, the journal publishes original research on the neurobiological, neurobehavioral, and pathophysiological processes associated with alcohol drinking, alcohol abuse, alcohol-seeking behavior, tolerance, dependence, withdrawal, protracted abstinence, and relapse. In addition, the journal reports studies on the effects alcohol on brain mechanisms of neuroplasticity over the life span, biological factors associated with adolescent alcohol abuse, pharmacotherapeutic strategies in the treatment of alcoholism, biological and biochemical markers of alcohol abuse and alcoholism, pathological effects of uncontrolled drinking, biomedical and molecular factors in the effects on liver, immune system, and other organ systems, and biomedical aspects of fetal alcohol spectrum disorder including mechanisms of damage, diagnosis and early detection, treatment, and prevention. Articles are published from all levels of biomedical inquiry, including the following: molecular and cellular studies of alcohol''s actions in vitro and in vivo; animal model studies of genetic, pharmacological, behavioral, developmental or pathophysiological aspects of alcohol; human studies of genetic, behavioral, cognitive, neuroimaging, or pathological aspects of alcohol drinking; clinical studies of diagnosis (including dual diagnosis), treatment, prevention, and epidemiology. The journal will publish 9 issues per year; the accepted abbreviation for Alcohol for bibliographic citation is Alcohol.