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001-es BibID:	BIBFORM112201
035-os BibID:	(cikkazonosító)e0194772 (Scopus)85046072083 (WOS)000431013300003
Első szerző:	Bowden, Bethan
Cím:	Risk of suicide following an alcohol-related emergency hospital admission : an electronic cohort study of 2.8 million people / Bethan Bowden, Ann John, Laszlo Trefan, Jennifer Morgan, Daniel Farewell, David Fone
Dátum:	2018
ISSN:	1932-6203
Megjegyzések:	Objective Alcohol misuse is a well-known risk factor for suicide however, the relationship between alcohol-related hospital admission and subsequent risk of death from suicide is unknown. We aimed to determine the risk of death from suicide following emergency admission to hospital with an alcohol-related cause. Methods We established an electronic cohort study of all 2,803,457 residents of Wales, UK, aged from 10 to under 100 years on 1 January 2006 with six years' follow-up. The outcome event was death from suicide defined as intentional self-harm (ICD-10 X60-84) or undetermined intent (Y10-34). The main exposure was an alcohol-related admission defined as a `wholly attributable' ICD-10 alcohol code in the admission record. Admissions were coded for the presence or absence of co-existing psychiatric morbidity. The analysis was by Cox regression with adjustments for confounding variables within the dataset. Results During the study follow-up period, there were 15,546,355 person years at risk with 28,425 alcohol-related emergency admissions and 1562 suicides. 125 suicides followed an admission (144.6 per 100,000 person years), of which 11 (9%) occurred within 4 weeks of discharge. The overall adjusted hazard ratio (HR) for suicide following admission was 26.8 (95% confidence interval (CI) 18.8 to 38.3), in men HR 9.83 (95% CI 7.91 to 12.2) and women HR 28.5 (95% CI 19.9 to 41.0). The risk of suicide remained substantial in subjects without known co-existing psychiatric morbidity: HR men 8.11 (95% CI 6.30 to 10.4) and women HR 24.0 (95% CI 15.5 to 37.3). The analysis was limited by the absence in datasets of potentially important confounding variables and the lack of information on alcohol-related harm and psychiatric morbidity in subjects not admitted to hospital. Conclusion Emergency alcohol-related hospital admission is associated with an increased risk of suicide. Identifying individuals in hospital provides an opportunity for psychosocial assessment and suicide prevention of a targeted at-risk group before their discharge to the community.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Plos One. - 13 : 4 (2018), p. 1-13. -
További szerzők:	John, Ann Trefán László (1969-) (biostatisztikus, bioinformatikus) Morgan, Jennifer Farewell, Daniel Fone, David
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM113422
Első szerző:	Fone, David
Cím:	Change in alcohol outlet density and alcohol-related harm to population health (CHALICE) : a comprehensive record-linked database study in Wales / David Fone, Jennifer Morgan, Richard Fry, Sarah Rodgers, Scott Orford, Daniel Farewell, Frank Dunstan, James White, Vas Sivarajasingam, Laszlo Trefan, Iain Brennan, Shin Lee, Narushige Shiode, Alison Weightman, Chris Webster and Ronan Lyons
Dátum:	2016
ISSN:	2050-4381 2050-439X
Megjegyzések:	What was the problem/question? We know that excess alcohol consumption causes harmful effects to health and also leads to violence. We did not know whether or not a change in the availability of alcohol could lead to a change in the harm caused by alcohol. Our aim was to study patterns of harm in Wales related to changes in alcohol availability. We also wanted to see if the amount of harm was different in areas that were higher or lower in social deprivation. What did we do? To measure alcohol availability we took the average of the distances between all households and all licensed alcohol premises within a small geographical area. We then analysed the link between our new measure of alcohol availability and anonymised data from the Welsh Health Survey, hospital records and the police. We looked at harmful outcomes such as excessive alcohol consumption, hospital admissions and violent crimes. What did we find? We found that higher availability of alcohol and change over time were related to an increase in alcohol-related harm. We found that the patterns of harm were not the same across Wales. We found that more deprived local authority areas had higher levels of poorer health caused by alcohol and more violent crime. What does this mean? Our results suggest that changes in alcohol availability are related to the harmful effects of alcohol. We are now sharing our findings with the NHS, local government and alcohol charities. We aim to influence policy and practice to improve population health and reduce health inequality.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Public Health Research. - 4 : 3 (2016), p. 1-184. -
További szerzők:	Morgan, Jennifer Fry, Richard Rodgers, Sarah Orford, Scott Farewell, Daniel Dunstan, Frank White, James Sivarajasingam, Vas Trefán László (1969-) (biostatisztikus, bioinformatikus) Brennan, Iain Lee, Shin Shiode, Narushige Weightman, Alison Webster, Chris Lyons, Ronan Anthony
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM112203
035-os BibID:	(WOS)000894823500025 (cikkazonosító)1373 (Scopus)85104890786
Első szerző:	Trefán László (biostatisztikus, bioinformatikus)
Cím:	Visualisation and optimisation of alcohol-related hospital admissions ICD-10 codes in Welsh e-cohort data / Laszlo Trefan, Ashley Akbari, Jennifer Siân Morgan, Daniel Mark Farewell, David Fone, Ronan A. Lyons, Hywel Merfyn Jones, Simon Moore
Dátum:	2021
ISSN:	2399-4908
Megjegyzések:	Introduction The excessive consumption of alcohol is detrimental to long term health and increases the likelihood of hospital admission. However, definitions of alcohol-related hospital admission vary, giving rise to uncertainty in the effect of alcohol on alcohol-related health care utilization. Objectives To compare diagnostic codes on hospital admission and discharge and to determine the ideal combination of codes necessary for an accurate determination of alcohol-related hospital admission. Methods Routine population-linked e-cohort data were extracted from the Secure Anonymised Information Linkage (SAIL) Databank containing all alcohol-related hospital admissions (n,= 92,553) from 2006 to 2011 in Wales, United Kingdom. The distributions of the diagnostic codes recorded at admission and discharge were compared. By calculating a misclassification rate (sensitivity-like measure) the appropriate number of coding fields to examine for alcohol-codes was established. Results There was agreement between admission and discharge codes. When more than ten coding fields were used the misclassification rate was less than 1%. Conclusion With the data at present and alcohol-related codes used, codes recorded at admission and discharge can be used equivalently to identify alcohol-related admissions. The appropriate number of coding fields to examine was established: fewer than ten is likely to lead to under-reporting of alcohol-related admissions. The methods developed here can be applied to other medical conditions that can be described using a certain set of diagnostic codes, each of which can be a known sole cause of the condition and recorded in multiple positions in e-cohort data.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	International Journal of Population Data Science. - 6 : 1 (2021), p. 1-12. -
További szerzők:	Akbari, Ashley Morgan, Jennifer Farewell, Daniel Fone, David Lyons, Ronan Anthony Jones, Hywel Merfyn Moore, Simon
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM112199
035-os BibID:	(Scopus)85066619998 (cikkazonosító)e0217598 (WOS)000470086200024
Első szerző:	Trefán László (biostatisztikus, bioinformatikus)
Cím:	Epidemiology of alcohol-related emergency hospital admissions in children and adolescents : an e-cohort analysis in Wales in 2006-2011 / Laszlo Trefan, Andrea Gartner, Amy Alcock, Daniel Farewell, Jennifer Morgan, David Fone, Shantini Paranjothy
Dátum:	2019
ISSN:	1932-6203
Megjegyzések:	Objective Harmful levels of alcohol consumption in young people are prevalent and of increasing public concern in the western world. Rates of alcohol-related emergency hospital admissions in children and young people between 10 to 17 years were described, and the reasons for these admissions and their association with socio-demographic factors were examined. Methods E-cohort data were extracted from the Secure Anonymised Information Linkage Databank, which contained alcohol-related emergency hospital admissions (N = 2968) from 2006 to 2011 in children and adolescents aged 10 to 17 years in Wales. A generalised linear mixed model was fitted using a log-link with a population offset to the data to calculate incident rate ratios (IRRSs). Results There was a general decreasing trend from 2006 to 2011 in the number and rate of alcoholrelated emergency hospital admissions; the mean age of admission was 15.4 (standard deviation 1.4) years. In each of the four youngest age groups (10?13,14,15,16 years), females had higher IRRs than males. Males had slightly higher IRR compared to females only in the oldest age group (17 years). IRRs increased with increasing deprivation. The majority (92%) of the admissions lasted one day and most of the admissions (70%) occured during the last three days of the week with a peak on Saturday. The length of stay in hospital was longer in cases when self-harm were present. Multiple admissions showed high prevalance of serio us self-harm cases in females. The number of admissions with injuries and falls were higher for males than females. Conclusion Female children and adolescents were more likely to be admitted to hospital for alcoholrelated reasons. These data illustrate the significant burden of alcohol-related harm in young people and highlight the need for interventions and policies that promote safe drinking practices among young people to prevent future alcohol-related harm during the life-course.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Plos One. - 14 : 6 (2019), p. 1-17. -
További szerzők:	Gartner, Andrea Alcock, Amy Farewell, Daniel Morgan, Jennifer Fone, David Paranjothy, Shantini
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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