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Eur J Epidemiol. 2003;18(7):631-42.

How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis.

Author information

  • 1Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne, Switzerland. ggmel@sfa-ispa.ch

Abstract

OBJECTIVE:

To determine the influence of six determining variables on the shape of the risk curve between alcohol and all-cause mortality.

METHODS:

DATA:

Based on a systematic search with clear inclusion criteria, all articles on alcohol and all-cause mortality until 2000 were included.

STATISTICAL METHODS:

Precision-weighted pooling of relative risks (RRs); precision-weighted hierarchical analysis.

VARIABLES:

For pooling: RRs for different categories of average volume of drinking, lifetime abstainers and ex-drinkers. For hierarchical analysis: on first level: consumption in grams of pure alcohol per day; on second level: length of follow-up time in months; per capita consumption; average age, proportion of abstainers, average volume of drinking, and variability of average volume of drinking at baseline.

OUTCOMES MEASURES:

RR of former and current drinkers for all-cause mortality compared to abstainers.

RESULTS:

The main hypotheses could be confirmed for males: Ex-drinkers had a higher mortality risk than lifetime abstainers; the higher and the more diverse the average volume of alcohol consumption, the wider the dip of the curve; the older the persons at baseline, the more pronounced the protective effect; and the longer the follow-up time, the less pronounced the protective effect. Except for average volume of drinking effects for females went in the same direction but with one exception did not reach significance.

CONCLUSIONS:

There are systematic influences on the shape of the risk curve between alcohol and all-cause mortality. The overall beneficial effect of light to moderate drinking remained under all scenarios, indicating a high validity of the overall shape despite the heterogeneity between studies.

PMID:
12952136
[PubMed - indexed for MEDLINE]
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