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Research article:
Alcohol-related mortality in patients with psoriasis: a population-based cohort study
Reference:
Parisi R; Webb RT; Carr MJ; Moriarty KJ; C Kleyn E; Griffiths CEM; Ashcroft DM(2017) Alcohol-related mortality in patients with psoriasis: a population-based cohort study. JAMA Dermatology, doi: 10.1001/jamadermatol.2017.3225
- Link to article
- Abstract
- 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 Datalink (CPRD) and linked to Hospital Episode Statistics (HES) and Office for National Statistics (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 deaths were 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.
- Author for correspondence
- Darren Ashcroft
- Email for correspondence
- Darren.Ashcroft@manchester.ac.uk
Code list: res61: alcohol consumption
191 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 136..00 | Read | Alcohol consumption | diagnostic | res61: alcohol consumption | |||
| 1361 | Read | Teetotaller | diagnostic | res61: alcohol consumption | |||
| 1361.11 | Read | Non drinker alcohol | diagnostic | res61: alcohol consumption | |||
| 1361.12 | Read | Non-drinker alcohol | diagnostic | res61: alcohol consumption | |||
| 1362 | Read | Trivial drinker - <1u/day | diagnostic | res61: alcohol consumption | |||
| 1362.11 | Read | Drinks rarely | diagnostic | res61: alcohol consumption | |||
| 1362.12 | Read | Drinks occasionally | diagnostic | res61: alcohol consumption | |||
| 1363 | Read | Light drinker - 1-2u/day | diagnostic | res61: alcohol consumption | |||
| 1364 | Read | Moderate drinker - 3-6u/day | diagnostic | res61: alcohol consumption | |||
| 1365 | Read | Heavy drinker - 7-9u/day | diagnostic | res61: alcohol consumption | |||
| 1366 | Read | Very heavy drinker - >9u/day | diagnostic | res61: alcohol consumption | |||
| 1367 | Read | Stopped drinking alcohol | diagnostic | res61: alcohol consumption | |||
| 136a.00 | Read | Increasing risk drinking | diagnostic | res61: alcohol consumption | |||
| 136A.00 | Read | Ex-trivial drinker (<1u/day) | diagnostic | res61: alcohol consumption | |||
| 136b.00 | Read | Feels should cut down drinking | diagnostic | res61: alcohol consumption | |||
| 136B.00 | Read | Ex-light drinker - (1-2u/day) | diagnostic | res61: alcohol consumption | |||
| 136c.00 | Read | Higher risk drinking | diagnostic | res61: alcohol consumption | |||
| 136C.00 | Read | Ex-moderate drinker - (3-6u/d) | diagnostic | res61: alcohol consumption | |||
| 136d.00 | Read | Lower risk drinking | diagnostic | res61: alcohol consumption | |||
| 136D.00 | Read | Ex-heavy drinker - (7-9u/day) | diagnostic | res61: alcohol consumption | |||
| 136E.00 | Read | Ex-very heavy drinker-(>9u/d) | diagnostic | res61: alcohol consumption | |||
| 136F.00 | Read | Spirit drinker | diagnostic | res61: alcohol consumption | |||
| 136G.00 | Read | Beer drinker | diagnostic | res61: alcohol consumption | |||
| 136H.00 | Read | Drinks beer and spirits | diagnostic | res61: alcohol consumption | |||
| 136I.00 | Read | Drinks wine | diagnostic | res61: alcohol consumption | |||
| 136J.00 | Read | Social drinker | diagnostic | res61: alcohol consumption | |||
| 136K.00 | Read | Alcohol intake above recommended sensible limits | diagnostic | res61: alcohol consumption | |||
| 136L.00 | Read | Alcohol intake within recommended sensible limits | diagnostic | res61: alcohol consumption | |||
| 136M.00 | Read | Current non drinker | diagnostic | res61: alcohol consumption | |||
| 136N.00 | Read | Light drinker | diagnostic | res61: alcohol consumption | |||
| 136O.00 | Read | Moderate drinker | diagnostic | res61: alcohol consumption | |||
| 136P.00 | Read | Heavy drinker | diagnostic | res61: alcohol consumption | |||
| 136Q.00 | Read | Very heavy drinker | diagnostic | res61: alcohol consumption | |||
| 136R.00 | Read | Binge drinker | diagnostic | res61: alcohol consumption | |||
| 136S.00 | Read | Hazardous alcohol use | diagnostic | res61: alcohol consumption | |||
| 136T.00 | Read | Harmful alcohol use | diagnostic | res61: alcohol consumption | |||
| 136V.00 | Read | Alcohol units per week | diagnostic | res61: alcohol consumption | |||
| 136W.00 | Read | Alcohol misuse | diagnostic | res61: alcohol consumption | |||
| 136X.00 | Read | Alcohol units consumed on heaviest drinking day | diagnostic | res61: alcohol consumption | |||
| 136Y.00 | Read | Drinks in morning to get rid of hangover | diagnostic | res61: alcohol consumption | |||
| 136Z.00 | Read | Alcohol consumption NOS | diagnostic | res61: alcohol consumption | |||
| 13Y8.00 | Read | Alcoholics anonymous | diagnostic | res61: alcohol consumption | |||
| 13ZY.00 | Read | Disqualified from driving due to excess alcohol | diagnostic | res61: alcohol consumption | |||
| 1462 | Read | H/O: alcoholism | diagnostic | res61: alcohol consumption | |||
| 1B1c.00 | Read | Alcohol induced hallucinations | diagnostic | res61: alcohol consumption | |||
| 1D19.00 | Read | Pain in lymph nodes after alcohol consumption | diagnostic | res61: alcohol consumption | |||
| 2577 | Read | O/E - breath - alcohol smell | diagnostic | res61: alcohol consumption | |||
| 2577.11 | Read | O/E - alcoholic breath | diagnostic | res61: alcohol consumption | |||
| 38Dz.00 | Read | Severity of alcohol dependence questionnaire | diagnostic | res61: alcohol consumption | |||
| 38Dz.11 | Read | SADQ - Severity of alcohol dependence questionnaire | diagnostic | res61: alcohol consumption | |||
| 63C7.00 | Read | Maternal alcohol abuse | diagnostic | res61: alcohol consumption | |||
| 66e..00 | Read | Alcohol disorder monitoring | diagnostic | res61: alcohol consumption | |||
| 66e0.00 | Read | alcohol abuse monitoring | diagnostic | res61: alcohol consumption | |||
| 7P22100 | Read | Delivery of rehabilitation for alcohol addiction | diagnostic | res61: alcohol consumption | |||
| 8BA8.00 | Read | alcohol detoxification | diagnostic | res61: alcohol consumption | |||
| 8CAM000 | Read | Advised to abstain from alcohol consumption | diagnostic | res61: alcohol consumption | |||
| 8CAv.00 | Read | advised to contact primary care alcohol worker | diagnostic | res61: alcohol consumption | |||
| 8G32.00 | Read | Aversion therapy - alcoholism | diagnostic | res61: alcohol consumption | |||
| 8H35.00 | Read | admitted to alcohol detoxification centre | diagnostic | res61: alcohol consumption | |||
| 8H7p.00 | Read | Referral to community alcohol team | diagnostic | res61: alcohol consumption | |||
| 8HHe.00 | Read | Referral to community drug and alcohol team | diagnostic | res61: alcohol consumption | |||
| 8HkG.00 | Read | Referral to specialist alcohol treatment service | diagnostic | res61: alcohol consumption | |||
| 8HkJ.00 | Read | Referral to alcohol brief intervention service | diagnostic | res61: alcohol consumption | |||
| 8IAF.00 | Read | brief intervention for excessive alcohol consumptn declined | diagnostic | res61: alcohol consumption | |||
| 8IAJ.00 | Read | declined referral to specialist alcohol treatment service | diagnostic | res61: alcohol consumption | |||
| 8IAt.00 | Read | Extended intervention for excessive alcohol consumption declined | diagnostic | res61: alcohol consumption | |||
| 9EQ..11 | Read | Police:venesect-alcohol | diagnostic | res61: alcohol consumption | |||
| 9k1..00 | Read | Alcohol misuse - enhanced services administration | diagnostic | res61: alcohol consumption | |||
| 9k11.00 | Read | Alcohol consumption counselling | diagnostic | res61: alcohol consumption | |||
| 9k12.00 | Read | Alcohol misuse - enhanced service completed | diagnostic | res61: alcohol consumption | |||
| 9k19.00 | Read | Alcohol assesment declined - enhanced services admin | diagnostic | res61: alcohol consumption | |||
| 9k1A.00 | Read | Brief intervention for excessive alcohol consumptn completed | diagnostic | res61: alcohol consumption | |||
| 9k1B.00 | Read | Extended intervention for excessive alcohol consumption completed | diagnostic | res61: alcohol consumption | |||
| 9NN2.00 | Read | Under care of community alcohol team | diagnostic | res61: alcohol consumption | |||
| C150500 | Read | Alcohol-induced pseudo-Cushing's syndrome | diagnostic | res61: alcohol consumption | |||
| E01..00 | Read | Alcoholic psychoses | diagnostic | res61: alcohol consumption | |||
| E010.00 | Read | Alcohol withdrawal delirium | diagnostic | res61: alcohol consumption | |||
| E011.00 | Read | Alcohol amnestic syndrome | diagnostic | res61: alcohol consumption | |||
| E011000 | Read | Korsakov's alcoholic psychosis | diagnostic | res61: alcohol consumption | |||
| E011100 | Read | Korsakov's alcoholic psychosis with peripheral neuritis | diagnostic | res61: alcohol consumption | |||
| E011200 | Read | Wernicke-Korsakov syndrome | diagnostic | res61: alcohol consumption | |||
| E011z00 | Read | Alcohol amnestic syndrome NOS | diagnostic | res61: alcohol consumption | |||
| E012.00 | Read | Other alcoholic dementia | diagnostic | res61: alcohol consumption | |||
| E012000 | Read | Chronic alcoholic brain syndrome | diagnostic | res61: alcohol consumption | |||
| E012.11 | Read | alcoholic dementia nos | diagnostic | res61: alcohol consumption | |||
| E013.00 | Read | Alcohol withdrawal hallucinosis | diagnostic | res61: alcohol consumption | |||
| E014.00 | Read | pathological alcohol intoxication | diagnostic | res61: alcohol consumption | |||
| E015.00 | Read | Alcoholic paranoia | diagnostic | res61: alcohol consumption | |||
| E01y.00 | Read | Other alcoholic psychosis | diagnostic | res61: alcohol consumption | |||
| E01y000 | Read | Alcohol withdrawal syndrome | diagnostic | res61: alcohol consumption | |||
| E01yz00 | Read | Other alcoholic psychosis NOS | diagnostic | res61: alcohol consumption | |||
| E01z.00 | Read | Alcoholic psychosis NOS | diagnostic | res61: alcohol consumption | |||
| E23..00 | Read | Alcohol dependence syndrome | diagnostic | res61: alcohol consumption | |||
| E230.00 | Read | Acute alcoholic intoxication in alcoholism | diagnostic | res61: alcohol consumption | |||
| E230000 | Read | Acute alcoholic intoxication, unspecified, in alcoholism | diagnostic | res61: alcohol consumption | |||
| E230100 | Read | Continuous acute alcoholic intoxication in alcoholism | diagnostic | res61: alcohol consumption | |||
| E230.11 | Read | Alcohol dependence with acute alcoholic intoxication | diagnostic | res61: alcohol consumption | |||
| E230200 | Read | Episodic acute alcoholic intoxication in alcoholism | diagnostic | res61: alcohol consumption | |||
| E230300 | Read | Acute alcoholic intoxication in remission, in alcoholism | diagnostic | res61: alcohol consumption | |||
| E230z00 | Read | Acute alcoholic intoxication in alcoholism NOS | diagnostic | res61: alcohol consumption | |||
| E231.00 | Read | Chronic alcoholism | diagnostic | res61: alcohol consumption | |||
| E231000 | Read | Unspecified chronic alcoholism | diagnostic | res61: alcohol consumption | |||
| E23..11 | Read | Alcoholism | diagnostic | res61: alcohol consumption | |||
| E231100 | Read | Continuous chronic alcoholism | diagnostic | res61: alcohol consumption | |||
| E231.11 | Read | Dipsomania | diagnostic | res61: alcohol consumption | |||
| E23..12 | Read | Alcohol problem drinking | diagnostic | res61: alcohol consumption | |||
| E231200 | Read | Episodic chronic alcoholism | diagnostic | res61: alcohol consumption | |||
| E231300 | Read | Chronic alcoholism in remission | diagnostic | res61: alcohol consumption | |||
| E231z00 | Read | Chronic alcoholism NOS | diagnostic | res61: alcohol consumption | |||
| E23z.00 | Read | Alcohol dependence syndrome NOS | diagnostic | res61: alcohol consumption | |||
| E250.00 | Read | Nondependent alcohol abuse | diagnostic | res61: alcohol consumption | |||
| E250000 | Read | Nondependent alcohol abuse, unspecified | diagnostic | res61: alcohol consumption | |||
| E250100 | Read | Nondependent alcohol abuse, continuous | diagnostic | res61: alcohol consumption | |||
| E250.11 | Read | Drunkenness NOS | diagnostic | res61: alcohol consumption | |||
| E250.12 | Read | Hangover (alcohol) | diagnostic | res61: alcohol consumption | |||
| E250.13 | Read | Inebriety NOS | diagnostic | res61: alcohol consumption | |||
| E250.14 | Read | Intoxication - alcohol | diagnostic | res61: alcohol consumption | |||
| E250200 | Read | Nondependent alcohol abuse, episodic | diagnostic | res61: alcohol consumption | |||
| E250300 | Read | Nondependent alcohol abuse in remission | diagnostic | res61: alcohol consumption | |||
| E250z00 | Read | Nondependent alcohol abuse NOS | diagnostic | res61: alcohol consumption | |||
| Eu10.00 | Read | [X]Mental and behavioural disorders due to use of alcohol | diagnostic | res61: alcohol consumption | |||
| Eu10000 | Read | [X]Mental & behav dis due to use alcohol: acute intoxication | diagnostic | res61: alcohol consumption | |||
| Eu10011 | Read | [X]Acute alcoholic drunkenness | diagnostic | res61: alcohol consumption | |||
| Eu10100 | Read | [X]Mental and behav dis due to use of alcohol: harmful use | diagnostic | res61: alcohol consumption | |||
| Eu10200 | Read | [X]Mental and behav dis due to use alcohol: dependence syndr | diagnostic | res61: alcohol consumption | |||
| Eu10211 | Read | [X]Alcohol addiction | diagnostic | res61: alcohol consumption | |||
| Eu10212 | Read | [X]Chronic alcoholism | diagnostic | res61: alcohol consumption | |||
| Eu10213 | Read | [X]Dipsomania | diagnostic | res61: alcohol consumption | |||
| Eu10300 | Read | [X]Mental and behavioural disorders due to use of alcohol: withdrawal state | diagnostic | res61: alcohol consumption | |||
| Eu10400 | Read | [X]Mental and behavioural disorders due to use of alcohol: withdrawal state with delirium | diagnostic | res61: alcohol consumption | |||
| Eu10411 | Read | [x]delirium tremens, alcohol induced | diagnostic | res61: alcohol consumption | |||
| Eu10500 | Read | [X]Mental and behavioural disorders due to use of alcohol: psychotic disorder | diagnostic | res61: alcohol consumption | |||
| Eu10511 | Read | [X]Alcoholic hallucinosis | diagnostic | res61: alcohol consumption | |||
| Eu10512 | Read | [x]alcoholic jealousy | diagnostic | res61: alcohol consumption | |||
| Eu10513 | Read | [X]Alcoholic paranoia | diagnostic | res61: alcohol consumption | |||
| Eu10514 | Read | [X]Alcoholic psychosis NOS | diagnostic | res61: alcohol consumption | |||
| Eu10600 | Read | [X]Mental and behavioural disorders due to use of alcohol: amnesic syndrome | diagnostic | res61: alcohol consumption | |||
| Eu10611 | Read | [x]korsakov's psychosis, alcohol induced | diagnostic | res61: alcohol consumption | |||
| Eu10700 | Read | [X]Mental and behavioural disorders due to use of alcohol: residual and late-onset psychotic disorde | diagnostic | res61: alcohol consumption | |||
| Eu10711 | Read | [X]Alcoholic dementia NOS | diagnostic | res61: alcohol consumption | |||
| Eu10712 | Read | [X]Chronic alcoholic brain syndrome | diagnostic | res61: alcohol consumption | |||
| Eu10800 | Read | [X]Alcohol withdrawal-induced seizure | diagnostic | res61: alcohol consumption | |||
| Eu10y00 | Read | [X]Mental and behavioural disorders due to use of alcohol: other mental and behavioural disorders | diagnostic | res61: alcohol consumption | |||
| Eu10z00 | Read | [X]Mental and behavioural disorders due to use of alcohol: unspecified mental and behavioural disord | diagnostic | res61: alcohol consumption | |||
| F11x000 | Read | Cerebral degeneration due to alcoholism | diagnostic | res61: alcohol consumption | |||
| F11x011 | Read | Alcoholic encephalopathy | diagnostic | res61: alcohol consumption | |||
| F144000 | Read | Cerebellar ataxia due to alcoholism | diagnostic | res61: alcohol consumption | |||
| F25B.00 | Read | Alcohol-induced epilepsy | diagnostic | res61: alcohol consumption | |||
| F375.00 | Read | Alcoholic polyneuropathy | diagnostic | res61: alcohol consumption | |||
| F394100 | Read | Alcoholic myopathy | diagnostic | res61: alcohol consumption | |||
| G555.00 | Read | Alcoholic cardiomyopathy | diagnostic | res61: alcohol consumption | |||
| G852300 | Read | Oesophageal varices in alcoholic cirrhosis of the liver | diagnostic | res61: alcohol consumption | |||
| J153.00 | Read | Alcoholic gastritis | diagnostic | res61: alcohol consumption | |||
| J610.00 | Read | Alcoholic fatty liver | diagnostic | res61: alcohol consumption | |||
| J611.00 | Read | Acute alcoholic hepatitis | diagnostic | res61: alcohol consumption | |||
| J612.00 | Read | Alcoholic cirrhosis of liver | diagnostic | res61: alcohol consumption | |||
| J612000 | Read | Alcoholic fibrosis and sclerosis of liver | diagnostic | res61: alcohol consumption | |||
| J613.00 | Read | Alcoholic liver damage unspecified | diagnostic | res61: alcohol consumption | |||
| J613000 | Read | Alcoholic hepatic failure | diagnostic | res61: alcohol consumption | |||
| J617.00 | Read | Alcoholic hepatitis | diagnostic | res61: alcohol consumption | |||
| J617000 | Read | Chronic alcoholic hepatitis | diagnostic | res61: alcohol consumption | |||
| J671000 | Read | Alcohol-induced chronic pancreatitis | diagnostic | res61: alcohol consumption | |||
| L255300 | Read | Maternal care for (suspected) damage to fetus from alcohol | diagnostic | res61: alcohol consumption | |||
| R103.00 | Read | [D]Alcohol blood level excessive | diagnostic | res61: alcohol consumption | |||
| SM0..00 | Read | Alcohol causing toxic effect | diagnostic | res61: alcohol consumption | |||
| SM00.00 | Read | Ethyl alcohol causing toxic effect | diagnostic | res61: alcohol consumption | |||
| SM00z00 | Read | Ethyl alcohol causing toxic effect NOS | diagnostic | res61: alcohol consumption | |||
| SM0z.00 | Read | Alcohol causing toxic effect NOS | diagnostic | res61: alcohol consumption | |||
| U60H300 | Read | [X]Alcohol deterrents causing adverse effects in therapeutic use | diagnostic | res61: alcohol consumption | |||
| U60H311 | Read | [X] Adverse reaction to alcohol deterrents | diagnostic | res61: alcohol consumption | |||
| U81..00 | Read | [X]Evid of alcohol involv determind by level of intoxication | diagnostic | res61: alcohol consumption | |||
| Z191.00 | Read | alcohol detoxification | diagnostic | res61: alcohol consumption | |||
| Z191100 | Read | alcohol withdrawal regime | diagnostic | res61: alcohol consumption | |||
| Z191200 | Read | Planned reduction of alcohol consumption | diagnostic | res61: alcohol consumption | |||
| Z191211 | Read | alcohol reduction programme | diagnostic | res61: alcohol consumption | |||
| Z191400 | Read | Self-monitoring of alcohol intake | diagnostic | res61: alcohol consumption | |||
| Z4B1.00 | Read | Alcoholism counselling | diagnostic | res61: alcohol consumption | |||
| ZC22200 | Read | Advice to change alcoholic drink intake | diagnostic | res61: alcohol consumption | |||
| ZC2H.00 | Read | Advice to change alcohol intake | diagnostic | res61: alcohol consumption | |||
| ZG23100 | Read | Advice on alcohol consumption | diagnostic | res61: alcohol consumption | |||
| ZR1E.00 | Read | Alcohol dependence scale | diagnostic | res61: alcohol consumption | |||
| ZR1E.11 | Read | ads - alcohol dependence scale | diagnostic | res61: alcohol consumption | |||
| ZR1G.00 | Read | Alcohol use inventory | diagnostic | res61: alcohol consumption | |||
| ZRa1100 | Read | Brief Michigan alcoholism screening test | diagnostic | res61: alcohol consumption | |||
| ZRk6.00 | Read | Severity of alcohol dependence questionnaire | diagnostic | res61: alcohol consumption | |||
| ZRk6.11 | Read | SADQ - Severity of alcohol dependence questionnaire | diagnostic | res61: alcohol consumption | |||
| ZV11300 | Read | [V]Personal history of alcoholism | diagnostic | res61: alcohol consumption | |||
| ZV11311 | Read | [V]Problems related to lifestyle alcohol use | diagnostic | res61: alcohol consumption | |||
| ZV4KC00 | Read | [V] Alcohol use | diagnostic | res61: alcohol consumption | |||
| ZV57A00 | Read | [V]Alcohol rehabilitation | diagnostic | res61: alcohol consumption | |||
| ZV6D600 | Read | [V]Alcohol abuse counselling and surveillance | diagnostic | res61: alcohol consumption |
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