Introduction
Material and methods
Study design and setting
Participants
Variables and data sources
Outcome variable
Predictor variables
Sample size
Missing data
Statistical analysis
Results
Participants
Baseline measurements
N = 3304 | |
---|---|
Italian citizen | 2068 (62.6%) |
Male sex | 2195 (66.4%) |
Age (years) | 30 (22; 43) |
Aged < 18 years | 172 (5.2%) |
Homeless | 262 (7.9%) |
Alcohol use disorder | 357 (10.8%) |
Substance use disorder | 175 (5.3%) |
More than 1 admission to ED for trauma | 425 (12.9%) |
Mental and behavioral disorders | 477 (14.4%) |
Neurological disorders | 257 (7.8%) |
Dementia | 12 (0.4%) |
Cirrhosis | 63 (1.9%) |
Cardiovascular disease | 138 (4.2%) |
Measurements at the last available admission
Alive N = 3171 | Dead N = 133 | |
---|---|---|
Italian citizen | 1950 (61.5%) | 118 (88.7%) |
Male sex | 2089 (65.9%) | 106 (79.7%) |
Age (years) | 29 (22; 43) | 61 (50; 73) |
Aged < 18 years | 172 (5.4%) | 0 (0.0%) |
Homeless | 273 (8.6%) | 24 (18.0%) |
Alcohol use disorder | 461 (14.5%) | 83 (62.4%) |
Substance use disorder | 190 (6.0%) | 26 (19.5%) |
More than 1 admission to ED for trauma | 557 (17.6%) | 75 (56.4%) |
Mental and behavioral disorders | 518 (16.3%) | 47 (35.3%) |
Neurological disorders | 267 (8.4%) | 44 (33.1%) |
Dementia | 10 (0.3%) | 8 (6.0%) |
Cirrhosis | 69 (2.2%) | 29 (21.8%) |
Cardiovascular disease | 119 (3.8%) | 41 (30.8%) |
Follow-up
Death rate associated with AUD, SUD, and their combination
Death | PY | Rate (95% CI) | ||
---|---|---|---|---|
AUD– | – | 50 | 25.25 | 1.98 (1.51–2.65) |
AUD+ | – | 83 | 4.80 | 17.30 (14.04–21.52) |
SUD– | – | 107 | 28.14 | 3.80 (3.16–4.62) |
SUD+ | – | 26 | 1.91 | 13.58 (9.36–20.37) |
AUD– | SUD– | 42 | 24.20 | 1.74 (1.29–2.38) |
AUD– | SUD+ | 8 | 1.05 | 7.60 (3.88–16.87) |
AUD+ | SUD– | 65 | 3.94 | 16.51 (13.05–21.16) |
AUD+ | SUD+ | 18 | 0.86 | 20.89 (13.35–34.22) |
Multivariable prediction of time-to-death
Model 1 | Model 2 | Model 3 | |
---|---|---|---|
Male | 1.64* [1.05–2.56] | 1.61* [1.01–2.57] | 1.68* [1.07–2.64] |
Baseline age/5 (years) | 1.48*** [1.39–1.58] | 1.49*** [1.39–1.58] | 1.48*** [1.40–1.58] |
Alcohol use disorder | 2.13*** [1.36–3.34] | 2.62*** [1.72–4.00] | – |
Substance use disorder | 3.69*** [2.13 to 6.41] | 4.22*** [2.47–7.21] | 4.00*** [2.25–7.11] |
More than 1 admission to ED for trauma | 2.02** [1.31–3.12] | – | 2.46*** [1.66–3.64] |
Mental and behavioral disorders | 0.96 [0.62–1.47] | 0.98 [0.64–1.51] | 1.10 [0.71–1.72] |
Neurological disorders | 1.46 [0.98–2.20] | 1.49 [0.98–2.28] | 1.62* [1.06–2.46] |
Liver cirrhosis | 2.54*** [1.58–4.08] | 2.73*** [1.71–4.37] | 3.07*** [1.87–5.05] |
Cardiovascular disease | 1.50 [0.94–2.40] | 1.62* [1.03–2.55] | 1.55 [0.96–2.50] |
AIC | 1645 | 1657 | 1657 |
BIC | 1706 | 1711 | 1711 |
Standardized mortality ratios
Age band (years) | PY | Obs. deaths | Exp. deaths | SMR (95% CI) |
---|---|---|---|---|
(15–20] | 765 | 0 | 0.15 | – |
(20–25] | 3685 | 0 | 1.11 | – |
(25–30] | 5161 | 2 | 1.55 | 1.29 (0.32–5.17) |
(30–35] | 4392 | 0 | 1.32 | – |
(35–40] | 3421 | 4 | 1.71 | 2.34 (0.88–6.23) |
(40–45] | 2871 | 8 | 2.30 | 3.48 (1.74–6.97) |
(45–50] | 2560 | 9 | 3.64 | 2.47 (1.29–4.75) |
(50–55] | 2114 | 12 | 4.86 | 2.47 (1.40–4.35) |
(55–60] | 1571 | 17 | 5.97 | 2.85 (1.77–4.58) |
(60–65] | 1193 | 17 | 7.99 | 2.13 (1.32–3.42) |
(65–70] | 832 | 10 | 9.15 | 1.09 (0.59–2.03) |
(70–75] | 572 | 11 | 10.76 | 1.02 (0.57–1.85) |
(75–80] | 334 | 18 | 11.16 | 1.61 (1.02 to 2.56) |
(80–85] | 250 | 10 | 15.25 | 0.66 (0.35 to 1.22) |
(85–90] | 187 | 11 | 22.30 | 0.49 (0.27 to 0.89) |
> 90 | 105 | 4 | 23.24 | 0.17 (0.06 to 0.46) |
Total | 30,053 | 133 | 122.44 | 1.09 (0.92 to 1.29) |