摘要：Objectives. We sought to determine gender- and age-specific attributable risks of all-cause and violence-related injuries associated with alcohol use. Methods. We used meta-analytic techniques to estimate attributable risks observed in emergency room studies conducted in 7 countries (n=17708). Results. In the case of both alcohol consumption before the injury event and individual drinking patterns, pooled attributable risk effect sizes for all-cause injuries were significant but minimal (2% to 6%). Effect sizes for violence-related injuries were 43% for drinking before an injury event and 27% for individual drinking pattern. Risks were greater for men, but no age-specific differences were found. Conclusions. This meta-analysis showed that attributable risk of injury is greater for drinking before the injury event than for drinking pattern; in addition, risks were more pronounced for violence-related injuries. Differences in risk were explained by variables related to sociocultural contexts. A strong association between alcohol use and injuries has been documented in the alcohol and injury literature, and much of this evidence has been derived from emergency room (ER) studies. 1, 2 Less is known about the attributable risk of injury associated with alcohol use (or the proportion of injury that would be eliminated in the absence of exposure to alcohol), an exposure measure that relies on estimates of injury risks among individuals exposed versus not exposed to alcohol. Most trauma studies have consisted of case series reports in which estimates of relative risk are not possible, necessitating the use of other data sources. 3, 4 Previous estimates of attributable risk have not included data derived from epidemiological studies involving probability samples of injury patients, nor do they reflect age-specific or culture-specific differences in relative risk. 5, 6 To fill this gap in the literature, we used meta-analytic techniques to analyze data on attributable risks associated with both alcohol consumption before an injury event (assessed via blood alcohol concentration [BAC] and self-reported consumption) and a consumption pattern in which 5 or more drinks at a time are consumed at least monthly (“5+ monthly drinking pattern”). We assessed the resulting effects on injury morbidity rates across 14 studies representing 30 ERs in 7 countries. We based our attributable risk estimates on comparisons of injured patients with non-injured patients, and we report separate estimates for all-cause injuries and violence-related injuries. 7, 8 We also report gender-specific and age-specific (younger than 30 years vs 30 years or older) estimates. In addition, we analyzed the extent to which study-specific sociocultural contextual variables explained observed differences in attributable risk estimates across studies. This analysis provided the opportunity for more fine-grained estimates of attributable risks of alcohol use associated with injury morbidity and for evaluation of the extent to which cultural variables explain observed differences across geographic localities.
