Differential mortality among alcoholics by sample site.

Abstract

The geometric mean measles antibody titer for the nine cases was 133 (95 per cent confidence limits of 126-141), for group A controls was 33 (95 per cent confidence limits of [28][29][30][31][32][33][34][35][36][37][38] and for group B controls 17 (95 per cent confidence limits of 11-24). The differences in the geometric mean titers between cases and both control groups are statistically significant (p < .01 for cases vs group A controls and p < .001 for cases vs group B controls by the student's t test). DiscussionAlthough the use of the jet injector gun has been associated with a slight increase in local reactions when used to administer diphtheria-tetanus toxoid,7 this problem has not been reported with measles vaccine. The adverse reactions seen were clinically identical to those described in the late 1960s by Scott and Buser3,4 and the statistically significant higher geometric mean antibody titer of the cases is similar to the findings of Fulginiti.8 The case-control study epidemiologically implicates the previously received killed vaccine.The mechanism of these reactions is not clear. One possible mechanism is an Arthus type phenomenon in a sensitized person, i.e., the prior killed-virus vaccine being the sensitizing factor and a later live-virus vaccine initiating the local tissue damage. Another possible mechanism is that following initial induction of cell mediated immunity by KMV, later challenge with live measles virus vaccine could initiate a delayed hypersensitivity reaction. A third mechanism is based on the finding that inactivated measles vaccine does not induce antibody to the F protein. Abstract: In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0 per cent, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Sample site must be considered as a variable in the study of mortality among alcoholics.

The prevalence of alcoholism and its relation to cause of hospitalization and long‐term mortality in male somatic inpatients

“…The selection of patients certainly affects the outcome of mortality studies. One report dealing with this problem disclosed the highest mortality rate in alcoholics recruited from medical and surgical services [3]. The conclusion about the excess death rate in that study was based upon life-table analyses.…”

“…Alcoholics treated at alcohol-treatment centres have a higher mortality rate than the general population [ l , 21. This has also been described in alcoholic inpatients from medical and surgical wards [3]. Because the worsened prognosis in these patients may be caused by an underlying somatic disorder, it would be adequate to compare mortality in these alcoholics with that of non-alcoholic inpatients.…”

Predictors of 16‐Year Mortality Among Individuals Initiating Help‐Seeking for an Alcoholic Use Disorder

“…These results agree with Barr et al's (1984) observation that when inpatient treatment does not succeed in modifying an AUD patient's drinking behavior, the patient has a higher risk of subsequent death. Other studies noted that mortality rates tend to be higher among substance use disorder patients receiving help in extended care settings, possibly because treatment in extended care reflects the patient's more severe medical problems and lack of socioeconomic resources (Combs-Orme et al, 1988;Lindberg and Agren, 1988;.…”

Maternal Alcohol Abuse and Neonatal Infection

“…The chronic use of alcohol suppresses the adult immune system, increasing the risk for a variety of infections (Adams and Jordan, 1984;Baker and Jerrells, 1993;Combs-Orme et al, 1983). Alcohol increases the risk of infection by altering the body's immune defenses against encapsulated bacteria (Baughman and Roselle, 1987).…”