Introduction
Background/rationale
Objective
Methods
Data source
Study population
Alcohol use disorders
Alcohol-attributable disease categories
Statistical analysis
Potential sources of bias for mortality calculations
Results
All-cause mortality risk
Characteristics | All Adults | Men | Women | |||
---|---|---|---|---|---|---|
n (%) | In-Hospital Death, n (%) | n (%) | In-Hospital Death, n (%) | n (%) | In-Hospital Death, n (%) | |
26,356,361 (100) | 1,506,334 (5.7) | 12,300,516 (46.7) | 816,259 (6.6) | 14,055,845 (53.3) | 690,075 (4.9) | |
Age at cohort inception (Jan. 1st, 2008) in years | ||||||
< 30 | 4,687,102 (17.8) | 11,077 (0.2) | 2,255,316 (18.3) | 7053 (0.3) | 2,431,786 (17.3) | 4024 (0.2) |
30–39 | 3,206,919 (12.2) | 19,546 (0.6) | 1,476,922 (12.0) | 10,888 (0.7) | 1,729,997 (12.3) | 8658 (0.5) |
40–49 | 4,007,783 (15.2) | 67,554 (1.7) | 1,902,807 (15.5) | 40,517 (2.1) | 2,104,976 (15.0) | 27,037 (1.3) |
50–59 | 4,658,741 (17.7) | 167,946 (3.6) | 2,336,423 (19.0) | 111,321 (4.8) | 2,322,318 (16.5) | 56,625 (2.4) |
60–69 | 3,782,817 (14.4) | 222,356 (5.9) | 1,894,887 (15.4) | 145,912 (7.7) | 1,887,930 (13.4) | 76,444 (4.1) |
70–79 | 3,603,656 (13.7) | 426,766 (11.8) | 1,605,710 (13.1) | 247,181 (15.4) | 1,997,946 (14.2) | 179,585 (9.0) |
80–89 | 2,108,262 (8.0) | 491,158 (23.3) | 754,991 (6.1) | 223,228 (29.6) | 1,353,271 (9.6) | 267,930 (19.8) |
≥ 90 | 301,081 (1.1) | 99,931 (33.2) | 73,460 (0.6) | 30,159 (41.1) | 227,621 (1.6) | 69,772 (30.7) |
Region of residency in Metropolitan France | ||||||
Greater Paris area | 4,450,245 (16.9) | 217,573 (4.9) | 2,014,604 (16.4) | 113,952 (5.7) | 2,435,641 (17.3) | 103,621 (4.3) |
North-West | 6,051,875 (23.0) | 373,476 (6.2) | 2,849,253 (23.2) | 206,088 (7.2) | 3,202,622 (22.8) | 167,388 (5.2) |
North-East | 6,023,280 (22.9) | 372,947 (6.2) | 2,806,326 (22.8) | 200,203 (7.1) | 3,216,954 (22.9) | 172,744 (5.4) |
South-West | 3,080,671 (11.7) | 175,921 (5.7) | 1,452,170 (11.8) | 95,699 (6.6) | 1,628,501 (11.6) | 80,222 (4.9) |
South-East | 6750,290 (25.6) | 366,417 (5.4) | 3,178,163 (25.8) | 200,317 (6.3) | 3,572,127 (25.4) | 166,100 (4.7) |
Tertiary care center | 6,458,321 (24.5) | 595,893 (9.2) | 3,040,223 (24.7) | 337,187 (11.1) | 3,418,098 (24.3) | 258,706 (7.6) |
Alcohol Use Disorders | 704,803 (2.7) | 112,752 (16.0) | 528,480 (4.3) | 89,165 (16.9) | 176,323 (1.3) | 23,587 (13.4) |
Cause-specific risks of hospital admission
Alcohol-Attributable Disease Category | Total, n (%) | AUDs, n (%) | Mean (SD) age at incidence | Hazard Ratio with AUDs (95% CI) | |
---|---|---|---|---|---|
AUDs | No AUDs | ||||
Liver diseases | |||||
Cirrhosis | 357,809 (2.91) | 155,000 (43.3) | 59.6 (12.0) | 64.9 (16.6) | 15.97 (15.86–16.09) |
Liver cancer | 56,162 (0.46) | 26,199 (46.7) | 65.3 (9.9) | 69.6 (12.4) | 16.12 (15.84–16.40) |
Pancreatic diseases | |||||
Acute pancreatitis | 80,860 (0.66) | 32,711 (40.5) | 48.8 (13.2) | 60.7 (18.0) | 12.14 (11.96–12.32) |
Chronic pancreatitis | 57,465 (0.47) | 31,602 (55.0) | 53.2 (12.3) | 62.3 (16.1) | 20.36 (20.01–20.71) |
Pancreatic cancer | 41,853 (0.34) | 3659 (8.7) | 62.2 (10.9) | 68.6 (12.0) | 1.61 (1.56–1.67) |
Upper aerodigestive tract cancers | |||||
Head and neck cancer | 82,852 (0.67) | 19,875 (24.0) | 57.8 (8.7) | 63.2 (11.9) | 4.39 (4.31–4.46) |
Larynx cancer | 37,952 (0.31) | 8399 (22.1) | 59.0 (8.9) | 64.9 (11.1) | 4.03 (3.93–4.14) |
Oesophageal cancer | 36,083 (0.29) | 6084 (16.9) | 60.7 (9.4) | 66.8 (11.5) | 3.19 (3.10–3.28) |
Colorectal cancer | 190,593 (1.55) | 10,427 (5.5) | 65.7 (10.3) | 69.5 (12.2) | 1.14 (1.11–1.16) |
Cardiovascular diseases | |||||
Ischemic heart disease | 1,290,533 (10.49) | 71,137 (5.5) | 62.6 (11.5) | 68.8 (12.8) | 1.11 (1.10–1.12) |
Congestive heart failure | 980,140 (8.0) | 76,602 (7.8) | 64.4 (12.1) | 73.4 (12.8) | 1.95 (1.94–1.97) |
Atrial fibrillation | 898,455 (7.30) | 54,639 (6.1) | 67.5 (11.5) | 74.4 (11.9) | 1.64 (1.63–1.66) |
Ischemic stroke | 432,393 (3.52) | 34,288 (7.9) | 63.8 (11.4) | 71.3 (13.0) | 1.75 (1.73–1.77) |
Haemorrhagic and other non-ischemic stroke | 108,219 (0.88) | 12,164 (11.2) | 59.6 (12.7) | 67.9 (16.9) | 2.23 (2.19–2.28) |
Dementia | 389,687 (3.17) | 47,349 (12.2) | 65.6 (13.2) | 80.5 (9.1) | 4.67 (4.63–4.72) |
Infectious diseases | |||||
Pneumococcal pneumonia | 28,569 (0.23) | 4799 (16.8) | 56.4 (12.9) | 64.7 (18.6) | 3.71 (3.60–3.83) |
Tuberculosis | 42,945 (0.35) | 4524 (10.5) | 57.4 (13.3) | 61.8 (20.3) | 2.22 (2.15–2.29) |
Injuries | |||||
Non-intentional injury | 357,461 (2.91) | 42,425 (11.9) | 56.7 (15.6) | 56.5 (24.1) | 3.11 (3.08–3.15) |
Self-harm | 144,723 (1.18) | 36,548 (25.3) | 43.1 (12.0) | 39.4 (17.1) | 6.55 (6.47–6.64) |
Other intentional injury | 32,113 (0.26) | 5966 (18.6) | 43.7 (21.9) | 36.7 (18.3) | 5.02 (4.88–5.17) |
Alcohol-Attributable Disease Category | Total, n (%) | AUDs, n (%) | Mean (SD) age at incidence | Hazard Ratio with AUDs (95% CI) | |
---|---|---|---|---|---|
AUDs | No AUDs | ||||
Liver diseases | |||||
Cirrhosis | 250,148 (1.78) | 52,348 (20.9) | 60.2 (12.5) | 65.6 (18.3) | 19.28 (10.09–19.47) |
Liver cancer | 21,171 (0.15) | 3690 (17.4) | 66.4 (11.2) | 71.7 (13.8) | 13.24 (12.76–13.73) |
Pancreatic diseases | |||||
Acute pancreatitis | 59,304 (0.42) | 6737 (11.4) | 50.4 (14.2) | 61.1 (20.9) | 8.56 (8.34–8.78) |
Chronic pancreatitis | 32,289 (0.23) | 6490 (20.1) | 54.0 (13.3) | 64.2 (17.8) | 15.36 (14.93–15.80) |
Pancreatic cancer | 38,627 (0.23) | 858 (2.2) | 63.6 (12.5) | 72.0 (13.2) | 1.44 (1.35–1.54) |
Upper aerodigestive tract cancers | |||||
Head and neck cancer | 24,814 (0.18) | 3255 (13.1) | 56.9 (9.0) | 65.3 (14.9) | 7.54 (7.26–7.83) |
Larynx cancer | 5267 (0.04) | 924 (17.5) | 57.6 (8.7) | 63.9 (13.0) | 9.68 (9.00–10.41) |
Esophageal cancer | 9399 (0.07) | 926 (9.9) | 61.0 (9.6) | 69.8 (13.2) | 6.23 (5.81–6.67) |
Colorectal cancer | 165,510 (1.18) | 2584 (1.6) | 67.3 (11.1) | 71.2 (13.7) | 1.09 (1.05–1.14) |
Breast cancer | 461,426 (3.28) | 6108 (1.3) | 62.3 (11.9) | 62.6 (14.4) | 0.65 (0.63–0.67) |
Cardiovascular diseases | |||||
Ischemic heart disease | 717,549 (5.10) | 12,170 (1.7) | 66.5 (13.1) | 76.1 (12.7) | 1.45 (1.43–1.48) |
Congestive heart failure | 829,405 (5.90) | 17,822 (2.2) | 68.4 (12.9) | 80.0 (11.6) | 2.35 (2.32–2.39) |
Atrial fibrillation | 818,585 (5.82) | 13,547 (1.7) | 71.9 (10.8) | 79.9 (10.4) | 1.84 (1.81–1.87) |
Ischemic stroke | 377,120 (2.68) | 8562 (2.3) | 65.9 (12.9) | 75.8 (14.2) | 1.92 (1.88–1.97) |
Hemorrhagic and other non-ischemic stroke | 100,700 (0.72) | 3864 (3.8) | 61.3 (13.1) | 72.0 (16.8) | 2.66 (2.58–2.75) |
Dementia | 675,778 (4.81) | 19,720 (2.9) | 69.4 (13.3) | 83.3 (8.1) | 4.27 (4.21–4.33) |
Infectious diseases | |||||
Pneumococcal pneumonia | 20,642 (0.15) | 1193 (5.8) | 55.5 (13.5) | 67.5 (20.0) | 4.35 (4.10–4.62) |
Tuberculosis | 36,103 (0.26) | 889 (2.5) | 59.8 (15.0) | 65.7 (20.8) | 1.80 (1.68–1.92) |
Injuries | |||||
Non-intentional injury | 404,365 (2.88) | 17,364 (4.3) | 61.5 (15.2) | 71.8 (20.5) | 4.49 (4.42–4.56) |
Self-harm | 223,769 (1.59) | 24,893 (11.1) | 45.2 (12.2) | 40.6 (18.0) | 8.90 (8.78–9.03) |
Other intentional injury | 17,958 (0.13) | 2619 (14.6) | 46.5 (13.3) | 46.5 (22.7) | 12.58 (12.05–13.13) |
Presence of alcohol-attributable disease categories at death and age at death
Men (n = 816,259) | Women (n = 690,194) | |||||||
---|---|---|---|---|---|---|---|---|
AUDs, n (%) | No AUDs, n (%) | Mean (SD) age at death | AUDs, n (%) | No AUDs, n (%) | Mean (SD) age at death | |||
AUDs | No AUDs | AUDs | No AUDs | |||||
89,165 (10.9) | 727,094 (89.1) | 64.8 (11.7) | 75.2 (13.3) | 23,587 (3.4) | 666,607 (96.6) | 65.5 (12.7) | 79.2 (13.4) | |
Alcohol-attributable disease categories | ||||||||
One or more disease categories | 83,039 (93.1) | 552,314 (76.0) | 65.0 (11.6) | 76.7 (12.4) | 22,064 (93.5) | 503,466 (75.5) | 65.8 (12.6) | 81.0 (12.1) |
Liver diseases | 57,298 (64.3) | 92,547 (12.7) | 64.5 (11.2) | 71.1 (13.1) | 16,770 (71.1) | 82,348 (12.4) | 64.7 (12.0) | 72.5 (14.1) |
Pancreatic diseases | 8372 (9.4) | 30,672 (4.2) | 61.8 (11.9) | 71.4 (12.1) | 1812 (7.7) | 28,149 (4.2) | 62.2 (13.3) | 75.5 (12.3) |
Upper aerodigestive tract cancer | 11,552 (13.0) | 42,250 (5.8) | 61.4 (9.3) | 67.9 (11.7) | 1685 (7.1) | 10,455 (1.6) | 60.5 (9.5) | 71.2 (13.5) |
Colorectal cancer | 3952 (4.4) | 51,606 (7.1) | 68.8 (10.0) | 74.5 (11.4) | 872 (3.7) | 42,223 (6.3) | 70.4 (10.5) | 76.7 (12.5) |
Cardiovascular diseases | 39,057 (43.8) | 406,023 (55.8) | 68.6 (11.2) | 78.8 (11.0) | 9291 (39.4) | 362,751 (54.4) | 70.5 (12.2) | 83.3 (10.2) |
Dementia | 13,557 (15.2) | 102,203 (14.1) | 69.7 (12.1) | 83.3 (7.7) | 4406 (18.7) | 129,161 (19.4) | 71.5 (12.7) | 86.1 (7.2) |
Infectious diseases | 2384 (2.7) | 14,298 (2.0) | 63.3 (12.2) | 75.5 (12.8) | 509 (2.2) | 9751 (1.5) | 63.5 (13.6) | 79.6 (12.5) |
Non-intentional injury | 6750 (7.6) | 41,903 (5.8) | 67.7 (12.4) | 79.2 (13.4) | 2280 (9.7) | 49,764 (7.5) | 69.8 (12.5) | 83.8 (10.4) |
Intentional injury | 2019 (2.3) | 5822 (0.8) | 60.0 (13.3) | 64.4 (20.2) | 881 (3.7) | 4824 (0.7) | 56.2 (12.6) | 68.0 (19.0) |
None of the above | 6126 (6.9) | 174,780 (24.0) | 61.0 (11.6) | 70.3 (14.9) | 1523 (6.5) | 163,141 (24.5) | 61.0 (12.2) | 73.6 (15.6) |
Breast cancer (Women) | 1412 (6.0) | 62,449 (9.4) | 67.2 (11.4) | 70.8 (14.4) |