Premium
Association Between Alcohol Screening Scores and Mortality in Black, Hispanic, and White Male Veterans
Author(s) -
Williams Emily C.,
Bradley Katharine A.,
Gupta Shalini,
Harris Alex H. S.
Publication year - 2012
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.2012.01842.x
Subject(s) - medicine , demography , logistic regression , ethnic group , veterans affairs , comorbidity , alcohol use disorders identification test , confidence interval , odds ratio , poison control , injury prevention , emergency medicine , sociology , anthropology
Background Scores on the Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questionnaire are associated with mortality, but whether or how associations vary across race/ethnicity is unknown. Methods Self‐reported black ( n = 13,068), Hispanic ( n = 9,466), and white ( n = 182,688) male V eterans A ffairs ( VA ) outpatients completed the AUDIT ‐ C via mailed survey. Logistic regression models evaluated whether race/ethnicity modified the association between AUDIT ‐ C scores (0, 1 to 4, 5 to 8, and 9 to 12) and mortality after 24 months, adjusting for demographics, smoking, and comorbidity. Results Adjusted mortality rates were 0.036, 0.033, and 0.054, for black, Hispanic, and white patients with AUDIT ‐ C scores of 1 to 4, respectively. Race/ethnicity modified the association between AUDIT ‐ C scores and mortality ( p = 0.0022). Hispanic and white patients with scores of 0, 5 to 8, and 9 to 12 had significantly increased risk of death compared to those with scores of 1 to 4; Hispanic OR s: 1.93, 95% CI 1.50 to 2.49; 1.57, 1.07 to 2.30; 1.82, 1.04 to 3.17, respectively; white OR s: 1.34, 95% CI 1.29 to 1.40; 1.12, 1.03 to 1.21; 1.81, 1.59 to 2.07, respectively. Black patients with scores of 0 and 5 to 8 had increased risk relative to scores of 1 to 4 ( OR s 1.28, 1.06 to 1.56 and 1.50, 1.13 to 1.99), but there was no significant increased risk for scores of 9 to 12 ( OR s 1.27, 0.77 to 2.09). Post hoc exploratory analyses suggested an interaction between smoking and AUDIT ‐ C scores might account for some of the observed differences across race/ethnicity. Conclusions Among male VA outpatients, associations between alcohol screening scores and mortality varied significantly depending on race/ethnicity. Findings could be integrated into systems with automated risk calculators to provide demographically tailored feedback regarding medical consequences of drinking.