Aims: To investigate the extent to which self-reported alcohol consumption level in the Scottish population is associated with first-time hospital admission for an alcohol-related cause.
Design: Observational record-linkage study.
Setting: Scotland, 1995-2005.
Participants: A total of 23,183 respondents aged 16 and over who participated in the 1995, 1998 and 2003 Scottish Health Surveys, followed-up via record-linkage from interview date until 30 September 2005.
Measurements: Rate of first-time hospital admission with at least one alcohol-related diagnosis. Cox proportional hazards regression analysis was applied to estimate the relative risk of first-time hospitalization with an alcohol-related condition associated with usual alcohol consumption level (1-7, 8-14, 15-21, 22-35, 36-49, 50+ units/week and ex-drinker, compared with <1 unit per week).
Findings: Of the SHS participants, 527 were hospitalized for an alcohol-related cause during 135,313 person-years of follow-up [39 first admissions per 10,000 person-years, 95% confidence interval (CI) 36-42]. Alcohol-related hospitalization rates were considerably higher for males (61/10,000 person-years, 95% CI 54-67) than for females (22/10,000 person-years, 95% CI 18-26). Compared with the lowest alcohol consumption category (<1 unit per week), the relative risk of first-time alcohol-related admission increased with reported consumption: age-adjusted hazard ratios ranged from 3 (1-5) for 1-7 units/week to 19 (10-37) for 50+ units/week (males); and from 2 (1-3) for 1-7 units/week to 28 (14-56) for 50+ units/week (females). After adjusting for age and usual alcohol consumption, the relative risk of first-time alcohol-related admission remained significantly higher for males reporting binge drinking and for both males and females residing in the most deprived localities.
Conclusions: Moderate and higher levels of usual alcohol consumption and binge drinking are serious risk factors for alcohol-related hospitalization in the Scottish population. These findings contribute to our understanding of the relationship between alcohol intake and alcohol-related morbidity.