The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population

Alcohol has been associated with COPD-related mortality but has not yet been demonstrated to be an independent risk factor for COPD exacerbation. Our objective was to evaluate the association between alcohol consumption and the subsequent risk of COPD exacerbation. A prospective cohort study of gene...

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Veröffentlicht in:Chest 2008-10, Vol.134 (4), p.761-767
Hauptverfasser: Greene, Courtney C., Bradley, Katharine A., Bryson, Chris L., Blough, David K., Evans, Laura E., Udris, Edmonds M., Au, David H.
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container_end_page 767
container_issue 4
container_start_page 761
container_title Chest
container_volume 134
creator Greene, Courtney C.
Bradley, Katharine A.
Bryson, Chris L.
Blough, David K.
Evans, Laura E.
Udris, Edmonds M.
Au, David H.
description Alcohol has been associated with COPD-related mortality but has not yet been demonstrated to be an independent risk factor for COPD exacerbation. Our objective was to evaluate the association between alcohol consumption and the subsequent risk of COPD exacerbation. A prospective cohort study of general medicine outpatients seen at one of seven Veterans Affairs (VA) medical centers who returned health screening questionnaires. Three screening questionnaires, AUDIT-C (0 to 12 points), CAGE (0 to 4 points), and a single item about the frequency of drinking six or more drinks on an occasion (binge drinking), were used to classify alcohol consumption. The main outcome, COPD exacerbation, was based on primary VA discharge diagnosis (International Classification of Diseases, Ninth Revision) or outpatient diagnosis of COPD accompanied by prescriptions for either antibiotics or prednisone within 2 days. Among the 30,503 patients followed up for a median of 3.35 years, those patients with AUDIT-C scores ≥ 6, CAGE scores ≥ 2, or who reported binge drinking at least weekly were at an increased risk of COPD exacerbation in age-adjusted analysis. Adjusted hazard ratios were 1.4 (95% confidence interval [CI], 1.1 to 1.7) for AUDIT-C score ≥ 6, 1.4 (95% CI, 1.3 to 1.5) for CAGE score ≥ 2, and 1.6 (95% CI, 1.2 to 2.2) for those who reported binge drinking daily or almost daily. However, with adjustment for measures of tobacco use, the association between alcohol consumption and increased risk of COPD exacerbation was no longer evident. Alcohol consumption, whether quantified by AUDIT-C, CAGE score, or binge drinking, was not associated with an increased risk of COPD exacerbation independent of tobacco use.
doi_str_mv 10.1378/chest.07-3081
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Vascular system</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Cohort Studies</topic><topic>COPD</topic><topic>epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumology</topic><topic>Pulmonary Disease, Chronic Obstructive - etiology</topic><topic>Pulmonary Disease, Chronic Obstructive - psychology</topic><topic>Pulmonary Disease, Chronic Obstructive - therapy</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Socioeconomic Factors</topic><topic>Surveys and Questionnaires</topic><topic>United States</topic><topic>Veterans - statistics &amp; numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greene, Courtney C.</creatorcontrib><creatorcontrib>Bradley, Katharine A.</creatorcontrib><creatorcontrib>Bryson, Chris L.</creatorcontrib><creatorcontrib>Blough, David K.</creatorcontrib><creatorcontrib>Evans, Laura E.</creatorcontrib><creatorcontrib>Udris, Edmonds M.</creatorcontrib><creatorcontrib>Au, David H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greene, Courtney C.</au><au>Bradley, Katharine A.</au><au>Bryson, Chris L.</au><au>Blough, David K.</au><au>Evans, Laura E.</au><au>Udris, Edmonds M.</au><au>Au, David H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2008-10-01</date><risdate>2008</risdate><volume>134</volume><issue>4</issue><spage>761</spage><epage>767</epage><pages>761-767</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Alcohol has been associated with COPD-related mortality but has not yet been demonstrated to be an independent risk factor for COPD exacerbation. Our objective was to evaluate the association between alcohol consumption and the subsequent risk of COPD exacerbation. A prospective cohort study of general medicine outpatients seen at one of seven Veterans Affairs (VA) medical centers who returned health screening questionnaires. Three screening questionnaires, AUDIT-C (0 to 12 points), CAGE (0 to 4 points), and a single item about the frequency of drinking six or more drinks on an occasion (binge drinking), were used to classify alcohol consumption. The main outcome, COPD exacerbation, was based on primary VA discharge diagnosis (International Classification of Diseases, Ninth Revision) or outpatient diagnosis of COPD accompanied by prescriptions for either antibiotics or prednisone within 2 days. Among the 30,503 patients followed up for a median of 3.35 years, those patients with AUDIT-C scores ≥ 6, CAGE scores ≥ 2, or who reported binge drinking at least weekly were at an increased risk of COPD exacerbation in age-adjusted analysis. Adjusted hazard ratios were 1.4 (95% confidence interval [CI], 1.1 to 1.7) for AUDIT-C score ≥ 6, 1.4 (95% CI, 1.3 to 1.5) for CAGE score ≥ 2, and 1.6 (95% CI, 1.2 to 2.2) for those who reported binge drinking daily or almost daily. However, with adjustment for measures of tobacco use, the association between alcohol consumption and increased risk of COPD exacerbation was no longer evident. Alcohol consumption, whether quantified by AUDIT-C, CAGE score, or binge drinking, was not associated with an increased risk of COPD exacerbation independent of tobacco use.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>18625671</pmid><doi>10.1378/chest.07-3081</doi><tpages>7</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Alcohol Drinking - adverse effects
alcohol drinking and adverse effect
Alcoholism - complications
Biological and medical sciences
Cardiology. Vascular system
Chronic obstructive pulmonary disease, asthma
Cohort Studies
COPD
epidemiology
Female
Humans
Male
Medical sciences
Middle Aged
Pneumology
Pulmonary Disease, Chronic Obstructive - etiology
Pulmonary Disease, Chronic Obstructive - psychology
Pulmonary Disease, Chronic Obstructive - therapy
Risk Factors
Smoking - adverse effects
Socioeconomic Factors
Surveys and Questionnaires
United States
Veterans - statistics & numerical data
title The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population
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