Episodic Alcohol Use and Risk of Nonfatal Injury

Abstract

Usual and acute alcohol consumption are important risk factors for injury. Although alcohol-dependent people are thought to be at increased risk of injury, there are few reports suggesting that their risk is greater than that of nondependent alcohol users in a given episode of alcohol use. The authors conducted a case-crossover analysis of data on 705 injury patients from a hospital emergency department in Mexico City, Mexico, collected in 2002. The majority of the sample was male (60%) and over 30 years old (51%). With use of a multiple matching approach that took into account three control time periods (the day prior to the injury, the same day in the previous week, and the same day in the previous month), the estimated relative risk of injury for patients who reported having consumed alcohol within 6 hours prior to injury (17% of the sample) was 3.97 (95% confidence interval: 2.88, 5.48). This increase in the relative risk was concentrated within the first 2 hours after drinking; there was a positive association of increasing risk with increasing number of drinks consumed. These data suggested that relative risk estimates were the same for patients with and without alcohol use disorders.

Multicentre study of acute alcohol use and non-fatal injuries: data from the WHO collaborative study on alcohol and injuries

“…Differen--tial recall may lead to an overestimate of the association between alcohol and injury if patients are more likely to remember and report alcohol use in the short term. Prior case-crossover research on alcohol consumption and injury has used other control periods, [1][2][3][4] ranging from a day to a year, suggesting that the findings reported here are robust. Legal or other issues, however, may encour--age patients to minimize their reports of drinking prior to an injury, for ex--ample, if they were involved in a traffic accident.…”

“…Following the method used in a prior report 4 we matched responses from two In some cases data do not add up to 4320 either because data were missing for whether alcohol was consumed 6 hours before the injury or due to weighting and rounding.…”

“…[1][2][3][4] These reports, along with others that have sampled patients in the general population, have concluded that alcohol use is associated with driving accidents, 5 violence, 6,7 suicide, 8 and inju--ries such as falls, trips and burns -that is, non-traffic injuries in general. [9][10][11][12][13][14] The unique feature of the case-crossover study is that this method allows the ef--fect of acute alcohol use to be separated from chronic effects of consumption (such as those that occur in people who abuse alcohol or are dependent on it).…”

“…19 Although these issues have been par--tially addressed in prior case-crossover reports, 1,4,20 which have found mixed results, an important factor in a detailed analysis of these issues is the small sample size used in most studies, which affects the power of the analysis of the effects on those who consume only small amounts of alcohol and the comparisons that are made across key modifiers of the effects. The WHO collaborative study on alco--hol and injuries 21 is a large multicentre survey of injured patients presenting in hospitals worldwide; its data can be used to help circumvent these limitations.…”

Substance use and associated diseases among injured persons

“…Hospital based study in Mexico City found the estimated relative risk of injury for patients who reported having consumed alcohol within 6 hours prior to injury was 3.97 (95% CI: 2.88, 5.48). 24 This increase in the relative risk was concentrated within the first 2 hours after drinking; there was a positive association of increasing risk with increasing number of drinks consumed. However, our study did not measure any alcohol drinks and related to injury.…”