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Alcohol-Related Mortality

Rosa Parisi, Roger T. Webb, Mathew J. Carr, Kieran J. Moriarty, Elise Kleyn, Christopher E. M. Griffiths, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH908
Version ID
1895
Data Sources
Valid event data range
01/01/1998 - 03/03/2014
Sex
Female, Male
Agreement Date
2017-09-15
Coding system
ICD10 codes ICD9 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

IMPORTANCE:

People diagnosed with psoriasis have an increased risk of premature mortality, but the underlying reasons for this mortality gap are unclear.

OBJECTIVE:

To investigate whether patients with psoriasis have an elevated risk of alcohol-related mortality.

DESIGN, SETTING, AND PARTICIPANTS:

An incident cohort of patients with psoriasis aged 18 years and older was delineated for 1998 through 2014 using the Clinical Practice Research atalink (CPRD) and linked to Hospital Episode Statistics (HES) and Office for National tatistics (ONS) mortality records. Patients with psoriasis were matched with up to 20 comparison patients without psoriasis on age, sex, and general practice.

MAIN OUTCOMES AND MEASURES:

Alcohol-related deathswere ascertained via the Office for National Statistics mortality records. A stratified Cox proportional hazard model was used to estimate the cause-specific hazard ratio for alcohol-related death, with adjustment for socioeconomic status.

RESULTS:

The cohort included 55 537 with psoriasis and 854 314 patients without psoriasis. Median (interquartile) age at index date was 47 (27) years; 408 230 of total patients (44.9%) were men. During a median (IQR) of 4.4 (6.2) years of follow-up, the alcohol-related mortality rate was 4.8 per 10 000 person-years (95%CI, 4.1-5.6; n = 152) for the psoriasis cohort, vs 2.5 per 10 000 (95%CI, 2.4- 2.7; n = 1118) for the comparison cohort. The hazard ratio for alcohol-related death in patients with psoriasis was 1.58 (95%CI, 1.31-1.91), and the predominant causes of alcohol-related deaths were alcoholic liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%), and mental and behavioral disorders due to alcohol (7.9%).

CONCLUSIONS AND RELEVANCE:

People with psoriasis have approximately a 60%greater risk of dying due to alcohol-related causes compared with peers of the same age and sex in the general population. This appears to be a key contributor to the premature mortality gap. These findings call for routine screening, identification and treatment, using the Alcohol Use Disorders Identification Test (AUDIT-C) in both primary and secondary care to detect alcohol consumption and misuse among people diagnosed with psoriasis.

Publications

  • Rosa Parisi, Roger T. Webb, Mathew J. Carr, Kieran J. Moriarty, Elise Kleyn, Christopher E. M. Griffiths, Darren M. Ashcroft, Alcohol-Related Mortality in Patients With Psoriasis A Population-Based Cohort Study. JAMA Dermatology, 153(12):1256-1262, 2017.

Clinical Code List

Rows: 6
Code Description Entity type Coding System (ICD-10 ICD-9) Category
291 Alcoholic psychoses res61: Alcohol-related mortality ICD-9 diagnostic
303 Alcohol dependence syndrome res61: Alcohol-related mortality ICD-9 diagnostic
305 Non-dependent abuse of alcohol res61: Alcohol-related mortality ICD-9 diagnostic
425.5 Alcoholic cardiomyopathy res61: Alcohol-related mortality ICD-9 diagnostic
571 Chronic liver disease and cirrhosis (Excluding 571.6 - Biliary cirrhosis) res61: Alcohol-related mortality ICD-9 diagnostic
E860 Accidental poisoning by alcohol res61: Alcohol-related mortality ICD-9 diagnostic
Rows: 12
Code Description Entity type Coding System (ICD-10 ICD-9) Category
F10 Mental and behavioural disorders due to use of alcohol res61: Alcohol-related mortality ICD-10 diagnostic
G31.2 Degeneration of nervous system due to alcohol res61: Alcohol-related mortality ICD-10 diagnostic
G62.1 Alcoholic polyneuropathy res61: Alcohol-related mortality ICD-10 diagnostic
I42.6 Alcoholic cardiomyopathy res61: Alcohol-related mortality ICD-10 diagnostic
K29.2 Alcoholic gastritis res61: Alcohol-related mortality ICD-10 diagnostic
K70 Alcoholic liver disease res61: Alcohol-related mortality ICD-10 diagnostic
K73 Chronic hepatitis, not elsewhere classified res61: Alcohol-related mortality ICD-10 diagnostic
K74 Fibrosis and cirrhosis of liver (Excluding K74.3?K74.5 - Biliary cirrhosis) res61: Alcohol-related mortality ICD-10 diagnostic
K86.0 Alcohol induced chronic pancreatitis res61: Alcohol-related mortality ICD-10 diagnostic
X45 Accidental poisoning by and exposure to alcohol res61: Alcohol-related mortality ICD-10 diagnostic
X65 Intentional self-poisoning by and exposure to alcohol res61: Alcohol-related mortality ICD-10 diagnostic
Y15 Poisoning by and exposure to alcohol, undetermined intent res61: Alcohol-related mortality ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH908/version/1895/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH908/version/1895/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH908', '1895', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH908/version/1895/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH908/version/1895/export/codes/?format=json
CSV site_root/phenotypes/PH908/version/1895/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH908', '1895', api_client=client)

Version History

Version
ID
Name Owner Publish date
1895 Alcohol-Related Mortality ieuan.scanlon 2022-04-04 currently shown

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