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Association of self-reported alcohol use and hospitalization for an alcohol-related cause in Scotland: a record-linkage study of 23 183 individuals

McDonald, S.A. and Hutchinson, S.J. and Bird, S.M. and Graham, L. and Robertson, C. and Mills, P.R. and Hayes, P. and Dillon, J.F. and Goldberg, D.J. (2009) Association of self-reported alcohol use and hospitalization for an alcohol-related cause in Scotland: a record-linkage study of 23 183 individuals. Addiction, 104 (4). pp. 593-602. ISSN 0965-2140

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Investigates the extent to which self-reported alcohol consumption level in the Scottish population is associated with first-time hospital admission for an alcohol-related cause. Design Observational record-linkage study. A total of 23 183 respondents aged 16 and over who participated in the 1995, 1998 and 2003 Scottish Health Surveys, followed-up via record-linkage from interview date until 30 September 2005. Measurements Rate of first-time hospital admission with at least one alcohol-related diagnosis. Cox proportional hazards regression analysis was applied to estimate the relative risk of first-time hospitalization with an alcohol-related condition associated with usual alcohol consumption level (1-7, 8-14, 15-21, 22-35, 36-49, 50+ units/week and ex-drinker, compared with <1 unit per week). Findings Of the SHS participants, 527 were hospitalized for an alcohol-related cause during 135 313 person-years of follow-up [39 first admissions per 10 000 personyears, 95% confidence interval (CI) 36-42]. Alcohol-related hospitalization rates were considerably higher for males (61/10 000 person-years, 95% CI 54-67) than for females (22/10 000 person-years, 95% CI 18-26). Compared with the lowest alcohol consumption category (<1 unit per week), the relative risk of first-time alcohol-related admission increased with reported consumption: age-adjusted hazard ratios ranged from 3 (1-5) for 1-7 units/week to 19 (10-37) for 50+ units/week (males); and from 2 (1-3) for 1-7 units/week to 28 (14-56) for 50+ units/week (females). After adjusting for age and usual alcohol consumption, the relative risk of first-time alcohol-related admission remained significantly higher for males reporting binge drinking and for both males and females residing in the most deprived localities. Moderate and higher levels of usual alcohol consumption and binge drinking are serious risk factors for alcohol-related hospitalization in the Scottish population. These findings contribute to our understanding of the relationship between alcohol intake and alcohol-related morbidity.