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EBioMedicine. 2015 Sep 2;2(10):1394-404. doi: 10.1016/j.ebiom.2015.08.040. eCollection 2015 Oct.

Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis.

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Université Claude Bernard Lyon I, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France ; Lundbeck SAS, 37-45, Quai du Président Roosevelt, Issy-les-Moulineaux, 92445 Paris, France.
Costello Medical Consulting, City House, 126-130 Hills Road, Cambridge, CB2 1RE, UK.
Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, CB1 8RN, UK.
University Alcohol Treatment Centre, Lausanne University Hospital, Rue du Bugnon 21, 1011 Lausanne, Switzerland.
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada ; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada ; Klinische Psychologie und Psychotherapie, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.



Alcohol dependence (AD) carries a high mortality burden, which may be mitigated by reduced alcohol consumption. We conducted a systematic literature review and meta-analysis investigating the risk of all-cause mortality in alcohol-dependent subjects.


MEDLINE, MEDLINE In-Process, Embase and PsycINFO were searched from database conception through 26th June 2014. Eligible studies reported all-cause mortality in both alcohol-dependent subjects and a comparator population of interest. Two individuals independently reviewed studies. Of 4540 records identified, 39 observational studies were included in meta-analyses.


We identified a significant increase in mortality for alcohol-dependent subjects compared with the general population (27 studies; relative risk [RR] = 3.45; 95% CI [2.96, 4.02]; p < 0.0001). The mortality increase was also significant compared to subjects qualifying for a diagnosis of alcohol abuse or subjects without alcohol use disorders (AUDs). Alcohol-dependent subjects continuing to drink heavily had significantly greater mortality than alcohol-dependent subjects who reduced alcohol intake, even if abstainers were excluded (p < 0.05).


AD was found to significantly increase an individual's risk of all-cause mortality. While abstinence in alcohol-dependent subjects led to greater mortality reduction than non-abstinence, this study suggests that alcohol-dependent subjects can significantly reduce their mortality risk by reducing alcohol consumption.


Abstinence; Alcohol dependence; Alcoholism; Meta-analysis; Mortality; Systematic review

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