Quantifying the global contribution of alcohol consumption to cardiomyopathy

Population Health Metrics

Research

Margaret Rylett¹  Sameer Imtiaz²  Jakob Manthey³  Maria Neufeld⁴  Jürgen Rehm⁵ 

[1] Institute for Mental Health Policy Research, CAMH, 33 Russell Street, M5S 2S1, Toronto, ON, Canada;Institute for Mental Health Policy Research, CAMH, 33 Russell Street, M5S 2S1, Toronto, ON, Canada;Institute of Medical Science (IMS), University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King’s College Circle, Room 2374, M5S 1A8, Toronto, ON, Canada;Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany;Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany;Institute for Mental Health Policy Research, CAMH, 33 Russell Street, M5S 2S1, Toronto, ON, Canada;Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany;Institute for Mental Health Policy Research, CAMH, 33 Russell Street, M5S 2S1, Toronto, ON, Canada;Campbell Family Mental Health Research Institute, 250 College Street, M5T 1R8, Toronto, ON, Canada;Institute of Medical Science (IMS), University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King’s College Circle, Room 2374, M5S 1A8, Toronto, ON, Canada;Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, M5T 3M7, Toronto, ON, Canada;PAHO/WHO Collaborating Centre for Mental Health and Addiction, 33 Russell Street, M5S 2S1, Toronto, ON, Canada;

关键词: Cardiomyopathy;    Population-attributable fraction;    Mortality;    Global burden of disease;    Alcohol;    Alcohol use disorder;    Comparative risk assessment;   

DOI  :  10.1186/s12963-017-0137-1

 received in 2016-12-19, accepted in 2017-05-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe global impact of alcohol consumption on deaths due to cardiomyopathy (CM) has not been quantified to date, even though CM contains a subcategory for alcoholic CM with an effect of heavy drinking over time as the postulated underlying causal mechanism. In this feasibility study, a model to estimate the alcohol-attributable fraction (AAF) of CM deaths based on alcohol exposure measures is proposed.MethodsA two-step model was developed based on aggregate-level data from 95 countries, including the most populous (data from 2013 or last available year). First, the crude mortality rate of alcoholic CM per 1,000,000 adults was predicted using a negative binomial regression based on prevalence of alcohol use disorders (AUD) and adult alcohol per capita consumption (APC) (n = 52 countries). Second, the proportion of alcoholic CM among all CM deaths (i.e., AAF) was predicted using a fractional response probit regression with alcoholic CM crude mortality rate (from Step 1), AUD prevalence, APC per drinker, and Global Burden of Disease region as predictions. Additional models repeated these steps by sex and for the wider Global Burden of Disease study definition of CM.ResultsThere were strong correlations (>0.9) between the crude mortality rate of alcoholic CM and the AAFs, supporting the modeling strategy. In the first step, the population-weighted mean crude mortality rate was estimated at 8.4 alcoholic CM deaths per 1,000,000 (95% CI: 7.4–9.3). In the second step, the global AAFs were estimated at 6.9% (95% CI: 5.4–8.4%). Sex-specific figures suggested a lower AAF among females (2.9%, 95% CI: 2.3–3.4%) as compared to males (8.9%, 95% CI: 7.0–10.7%). Larger deviations between observed and predicted AAFs were found in Eastern Europe and Central Asia.ConclusionsThe model proposed promises to fill the gap to include AAFs for CM into comparative risk assessments in the future. These predictions likely will be underestimates because of the stigma involved in all fully alcohol-attributable conditions and subsequent problems in coding of alcoholic CM deaths.

【 授权许可】

CC BY   
© The Author(s). 2017