scholarly journals Electronic Longitudinal Alcohol Study in Communities (ELAStiC) Wales – protocol for platform development

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Laszlo Trefan ◽  
Ashley Akbari ◽  
Shantini Paranjothy ◽  
Daniel Mark Farewell ◽  
Andrea Gartner ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Routine Data ◽  
Population Data ◽  
Population Based ◽  
Mortality Data ◽  
Health Trajectories ◽  
Platform Development ◽  
The Uk ◽  
Alcohol Related Harm ◽  
Related Harm

IntroductionExcessive alcohol consumption has adverse effects on health and there is a recognised need for thelongitudinal analysis of population data to improve our understanding of the patterns of alcohol use,harms to consumers and those in their immediate environment. The UK has a number of linkable,longitudinal databases that if assembled properly could support valuable research on this topic. Aims and objectivesThis paper describes the development of a broad set of cross-linked cohorts, e-cohorts, surveys andlinked electronic healthcare records (EHRs) to construct an alcohol-specific analytical platform inthe United Kingdom using datasets on the population of Wales. The objective of this paper is to provide a description of existing key datasets integrated withexisting, routinely collected electronic health data on a secure platform, and relevant derived variablesto enable population-based research on alcohol-related harm in Wales. We illustrate our use of thesedata with some exemplar research questions that are currently under investigation. MethodsRecord-linkage of routine and observational datasets. Routine data includes hospital admissions,general practice, and cohorts specific to children. Two observational studies were included. Routinesocioeconomic descriptors and mortality data were also linked. ConclusionWe described a record-linked, population-based research protocol for alcohol related harm on a secureplatform. As the datasets used here are available in many countries, ELAStiC provides a templatefor setting up similar initiatives in other countries. We have also defined a number of alcohol specificvariables using routinely-collected available data that can be used in other epidemiological studiesinto alcohol related outcomes. With over 10 years of longitudinal data, it will help to understandalcohol-related disease and health trajectories across the lifespan.

scholarly journals The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ashley Akbari ◽  
Ronan Lyons ◽  
Damon Berridge ◽  
John Gallacher ◽  
John MacLeod ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Alcohol Consumption ◽  
Longitudinal Data ◽  
Routine Data ◽  
Household Composition ◽  
Police Data ◽  
The Uk ◽  
Alcohol Related Harm ◽  
Related Harm

ABSTRACT ObjectivesThe ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project was established to determine factors that predict pathways into alcohol misuse and the life-course effects of alcohol use and misuse on health and well-being. This is achieved through accessing existing longitudinal data that are key sources of evidence for social and health policy, developing statistical methods and modelling techniques from a diverse range of disciplines, working with stakeholders in both policy, practice and the third sector to bring relevance to the work, and to bring together a diverse team of experts to collaborate and facilitate learning across diverse fields. ApproachThe project will link data that include cohort studies such as; UK Biobank, ALSPAC (Avon Longitudinal Study of Parents and Children), Millennium Cohort Study, British Household Panel Survey, Understanding Society, E_CATALyST (Caerphilly Health and Social Needs Electronic Cohort Study) and WECC (Wales Electronic Cohort for Children). These data will be linked with routine data from primary and secondary healthcare in England, Scotland and Wales. Additional data from education and police data source will also be linked as part of the project. The main work packages for the project are: Methodological InnovationsMethodological developments in mechanisms for correcting bias in reporting alcohol consumption and for combining routine data with cohort data; the application of Markov models for examining the extent to which past behaviour influences future behaviour, and econometric hedonic pricing methods for providing insights into the costs of alcohol-related harm. Pathways into HarmDo family structure, household composition, youngsters’ previous ill-health and educational attainment predict their use of alcohol and what socio-economic factors and household transitions contribute to hazardous alcohol consumption in adults? Secondary HarmsWhat is the effect on children’s health and educational achievement of living in households in which one or more adults has experienced alcohol-related harm? Mental Health & Well-BeingWhat is the relationship between alcohol consumption, hospital admission and mental health in adults and children? ResultsThe results of the data linkage between the multiple cohorts and health, education and police data will be reported. The challenges of linking cohort and other data types from different nations will be discussed. ConclusionsOur project will aim to provide evidence that informs the UK Government’s commitment to “radically reshape the approach to alcohol and reduce the number of people drinking to excess”, by working with existing longitudinal data collected in the UK to inform policy and practice.

scholarly journals The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK

2012 ◽  
Vol 201 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Peter Rice ◽  
Colin Drummond
Keyword(s):  
Control Measures ◽  
The Past ◽  
Alcohol Control ◽  
Health Measure ◽  
Alcohol Taxation ◽  
Unit Pricing ◽  
The Uk ◽  
The Impact ◽  
Alcohol Related Harm ◽  
Related Harm

SummaryThe UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

scholarly journals Alcohol-related injury admission trends in adolescents: A comparison between Western Australia and England

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Melissa O'Donnell ◽  
Scott Sims ◽  
Miriam Maclean ◽  
Arturo Gonzalez-Izquierdo ◽  
Ruth Gilbert ◽  
...  
Keyword(s):  
Young People ◽  
Western Australia ◽  
Hospital Admissions ◽  
Age Groups ◽  
Unintentional Injury ◽  
Incidence Rates ◽  
Public Health Issue ◽  
Injury Rates ◽  
Alcohol Related Harm ◽  
Related Harm

ABSTRACTObjectivesThis study aims to determine trends in hospital admissions for alcohol-related injuries among young people in Western Australia and England and whether these admissions are intentionally or unintentionally caused. In addition, this study examines variation in trends by sex and age-groups to determine groups most at risk. ApproachAnnual incidence rates for alcohol-related injury rates were calculated using hospital admissions data for Western Australia and England. We compared trends in different types of alcohol-related injury by age and gender. ResultsAlcohol-related injuries have increased significantly from 1980-2009 (from 2 to 12 per 10,000). Conversely, alcohol-related injury rates have declined in England since 2007. In England self-harm is the most frequently recorded cause of alcohol-related injury. In Western Australia, unintentional injury is most common, however violence-related harm is increasing for boys and girls. Boys aged 16-17 in Western Australia had the highest rate of alcohol-related injury (27.1/10,000), which was markedly higher than for 16-17 year old girls in Western Australia (16.6/10,000), girls in England (14.1/10,000), or boys in England (13.2/10,000). ConclusionAlcohol-related harm is a significant public health issue, and in Western Australia there is a concerning trend of increasing alcohol-related injuries among young people. Alcohol-related harm of sufficient severity to require hospital admission is increasing among adolescents in Western Australia. Declining trends in England suggests this trend is not inevitable or irreversible. More needs to be done to address alcohol-related harm, and ongoing monitoring is required to assess the effectiveness of strategies.

Alcohol Consumption and the Experience of Adverse Consequences—A Comparison of Six European Countries

2002 ◽  
Vol 29 (3) ◽  
pp. 549-575 ◽  
Author(s):  
Mats Ramstedt
Keyword(s):  
Binge Drinking ◽  
Positive Association ◽  
European Countries ◽  
Southern Europe ◽  
Multivariate Logistic Regression ◽  
Risk Curve ◽  
The Uk ◽  
Alcohol Related Harm ◽  
Alcohol Related Problems ◽  
Related Harm

This paper describes prevalence rates of self-reported experiences of alcohol-related problems in six Western European countries and examines how self-reported consumption of alcohol is associated with the likelihood of experiencing these problems. Of particular interest is to assess whether alcohol is more strongly associated with the likelihood of experiencing adverse consequences in Northern Europe than in countries in Central and Southern Europe. Data on self-reported volume of drinking and binge drinking and of experiences of various alcohol-related problems from a general population survey undertaken in Finland, Sweden, Germany, the UK, France and Italy during the spring of 2000 were analyzed. The number of respondents was about 1,000 men and women (ages 18–64) in each country. In the assessment of the link between drinking and harm, results showed that the overall prevalence of alcohol-related harm was highest in Finland and the UK and lowest in Southern Europe. A general positive association was found between volume of drinking and problems, although some country differences were observed. The risk curve analysis also revealed that problems occurred at fairly low drinking levels. In the multivariate logistic regression analyses, the volume of drinking and a measure of binge drinking were both statistically significant predictors of most problems in most countries. A major conclusion is that both volume of drinking and binge drinking are important determinants of the risk of experiencing adverse consequences from drinking in all six European countries.

Hyperglycaemic crises in adult patients with diabetes mellitus

2011 ◽  
pp. 1874-1888 ◽  
Author(s):  
Abbas E. Kitabchi ◽  
Ebenezer Nyenwe
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Hospital Admissions ◽  
Population Based ◽  
Patients With Diabetes ◽  
The Usa ◽  
The Uk

Diabetic ketoacidosis (DKA) and hyperosmolar nonketotic state (HONK; also referred to, in the USA, as hyperglycaemic hyperosmolar state) are the two most serious, potentially fatal acute metabolic complications of diabetes mellitus. In the USA, the annual incidence rate for DKA ranges from 4.6 to 8 episodes per 1000 patients with diabetes of all ages, and 13.4 per 1000 patients in subjects younger than 30 years old (1). The incidence rate in the USA is comparable to the rates in Europe, with estimates of 13.6 per 1000 patients with type 1 diabetes in the UK (2), and 14.9 per 1000 patients with type 1 diabetes in Sweden (3). In the USA, hospitalization for DKA has risen by more than 30% in the last decade, with DKA accounting for approximately 1 35 000 hospital admissions in 2006 (4). The incidence of HONK is difficult to determine because of the lack of population–based studies and the multiple combined illnesses often found in these patients. In general, it is estimated that the rate of hospital admissions due to HONK is lower than it is for DKA and HONK accounts for less than 1% of all primary diabetic admissions (5). The mortality rate in patients with DKA has significantly decreased in experienced centres since the advent of low-dose insulin and appropriate fluid-/electrolyte-replacement protocols. Among adults with DKA in the USA, the overall mortality rate is less than 1% (4). A trend toward remarkable reduction in mortality from DKA has been reported in Europe as well, with one UK university recording no deaths among 46 patients who were admitted for DKA between 1997 and 1999 (2). The incidence and mortality of DKA remains high in developing countries, owing to socioeconomic factors. For instance, in Nairobi, Kenya, the incidence of DKA was about 80 per 1000 hospitalized diabetic patients in a study reported in 2005, and mortality rate was as high as 30% (6). The mortality rate of patients with HONK remains high even in the developed world, at approximately 11%. The prognosis of both conditions is substantially worsened with increased age, presence of coma, and hypotension (7). Despite threat to life, DKA is also expensive, with estimated annual direct and indirect cost of 2 billion US dollars (8).

scholarly journals Drinking beer, wine or spirits – does it matter for inequalities in alcohol-related hospital admission? A record-linked longitudinal study in Wales

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrea Gartner ◽  
Laszlo Trefan ◽  
Simon Moore ◽  
Ashley Akbari ◽  
Shantini Paranjothy ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Hospital Admissions ◽  
Health Condition ◽  
Housing Tenure ◽  
Alcoholic Beverages ◽  
Individual Level ◽  
Beverage Type ◽  
Alcohol Related Harm ◽  
Related Harm ◽  
Deprived Areas

Abstract Background Alcohol-related harm has been found to be higher in disadvantaged groups, despite similar alcohol consumption to advantaged groups. This is known as the alcohol harm paradox. Beverage type is reportedly socioeconomically patterned but has not been included in longitudinal studies investigating record-linked alcohol consumption and harm. We aimed to investigate whether and to what extent consumption by beverage type, BMI, smoking and other factors explain inequalities in alcohol-related harm. Methods 11,038 respondents to the Welsh Health Survey answered questions on their health and lifestyle. Responses were record-linked to wholly attributable alcohol-related hospital admissions (ARHA) eight years before the survey month and until the end of 2016 within the Secure Anonymised Information Linkage (SAIL) Databank. We used survival analysis, specifically multi-level and multi-failure Cox mixed effects models, to calculate the hazard ratios of ARHA. In adjusted models we included the number of units consumed by beverage type and other factors, censoring for death or moving out of Wales. Results People living in more deprived areas had a higher risk of admission (HR 1.75; 95% CI 1.23–2.48) compared to less deprived. Adjustment for the number of units by type of alcohol consumed only reduced the risk of ARHA for more deprived areas by 4% (HR 1.72; 95% CI 1.21–2.44), whilst adding smoking and BMI reduced these inequalities by 35.7% (HR 1.48; 95% CI 1.01–2.17). These social patterns were similar for individual-level social class, employment, housing tenure and highest qualification. Inequalities were further reduced by including either health status (16.6%) or mental health condition (5%). Unit increases of spirits drunk were positively associated with increasing risk of ARHA (HR 1.06; 95% CI 1.01–1.12), higher than for other drink types. Conclusions Although consumption by beverage type was socioeconomically patterned, it did not help explain inequalities in alcohol-related harm. Smoking and BMI explained around a third of inequalities, but lower socioeconomic groups had a persistently higher risk of (multiple) ARHA. Comorbidities also explained a further proportion of inequalities and need further investigation, including the contribution of specific conditions. The increased harms from consumption of stronger alcoholic beverages may inform public health policy.

scholarly journals Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.

2019 ◽  
Vol 4 ◽  
pp. 49 ◽  
Author(s):  
Robert W Aldridge ◽  
Dee Menezes ◽  
Dan Lewer ◽  
Michelle Cornes ◽  
Hannah Evans ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Hospital Admissions ◽  
Social Deprivation ◽  
Homeless People ◽  
Population Based ◽  
Cross Sectional Study ◽  
Mortality Data ◽  
Cross Sectional ◽  
Icd 10 ◽  
External Causes

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.

scholarly journals Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK

2012 ◽  
Vol 94 (8) ◽  
pp. 559-562 ◽  
Author(s):  
SJC Fishpool ◽  
A Tomkinson
Keyword(s):  
Hospital Admissions ◽  
Population Data ◽  
Male Population ◽  
Female Population ◽  
Admission Rates ◽  
Patient Admissions ◽  
Group A ◽  
The One ◽  
The Uk ◽  
Age And Sex

INTRODUCTION Epistaxis is the one of the most common otorhinolaryngology emergencies. This study examined the age and sex distribution of all patients admitted with epistaxis to National Health Service (NHS) hospitals in Wales, UK, over a period of 18 years and 9 months. METHODS The Patient Episode Database for Wales was examined for all patient admissions with a diagnosis of epistaxis between April 1991 and December 2009. The age and sex of these patients was recorded and the proportion of the underlying population affected was calculated by comparing admission rates to the population data derived from the 1991 and 2001 national population censuses for Wales. RESULTS A total of 26,725 patients were admitted to NHS hospitals in Wales with epistaxis over the period studied. The proportion of the population admitted with epistaxis increased from the age of 40 onwards. For all ages except patients in the 10–14 years group, a higher proportion of the male population was admitted with epistaxis than the comparable female population. This discrepancy was most pronounced between the ages of 15 and 49 years, with the female-to-male ratio of hospital admissions with epistaxis being 0.55. These ages (15 and 49 years) approximate the average age of menarche and menopause respectively in the UK. CONCLUSIONS Women of menstrual age have fewer hospital admissions with epistaxis. This may be due to oestrogens providing protection to the nasal vasculature (as they do to other areas of the vascular tree).

scholarly journals Trends in occurrence and 30-day mortality of infective endocarditis in adults: population-based registry study in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026811 ◽  
Author(s):  
Elina Ahtela ◽  
Jarmo Oksi ◽  
Pekka Porela ◽  
Tommi Ekström ◽  
Paivi Rautava ◽  
...  
Keyword(s):  
Sex Differences ◽  
Infective Endocarditis ◽  
Incidence Rate ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
Population Based ◽  
Mortality Data ◽  
Annual Increase ◽  
Rate Ratios ◽  
Age And Sex

ObjectivesInfective endocarditis (IE) is a life-threatening disease associated with significant mortality. We studied recent temporal trends and age and sex differences in the occurrence and short-term mortality of IE.DesignPopulation based retrospective cohort study.SettingData of IE hospital admissions in patients aged ≥18 years in Finland during 2005–2014 and 30-day all-cause mortality data were retrospectively collected from mandatory nationwide registries from 38 hospitals.OutcomesTrends and age and sex differences in occurrence. Thirty-day mortality.ResultsThere were 2611 cases of IE during the study period (68.2% men, mean age 60 years). Female patients were significantly older than males (62.0 vs 59.0 years, p=0.0004). Total standardised annual incidence rate of IE admission was 6.33/100 000 person-years. Men had significantly higher risk of IE compared with women (9.5 vs 3.7/100 000; incidence rate ratios [IRR] 2.49; p<0.0001) and difference was most prominent at age 40–59 years (IRR 4.49; p<0.0001). Incidence rate varied from 5.7/100 000 in 2005 to 7.1/100 000 in 2012 with estimated average 2.1% increase per year (p=0.036) and similar trends in both sexes. Significant increasing trend was observed in patients aged 18–29 years and 30–39 years (estimated annual increase 7.6% and 7.2%, p=0.002) and borderline in patients aged 40–49 years (annual increase 3.8%, p=0.08). In older population, IE incidence rate remained stable. The overall 30-day mortality after IE admission was 11.3%. Mortality was similar between sexes, increased with ageing, and remained similar during the study period.ConclusionsOccurrence of IE is increasing in young adults in Finland. Men, especially middle-aged, are at higher risk for IE compared with women. Thirty-day mortality has remained stable at 11%, increased with ageing, and was similar between sexes.

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