Epidemiology of hospitalization due to alcohol-related harm: evidence from a Scottish cohort study.

Objective: To examine a broad range of risk factors and their association with alcohol-related hospital admissions in a Scottish general population.

Design: Observational record-linkage study in Scotland from 1998 to 2008 involving 8305 respondents aged 16-74 years who participated in the 1998 Scottish Health Survey. Outcome was defined as first-time hospital admission with at least one alcohol-related diagnosis.

Methods: Cox proportional hazards modelling was applied to estimate the hazard ratio (HR) of first-time hospitalization with an alcohol-related condition associated with a range of behavioural, social and biological risk factors.

Findings: In total, 287 (3.4%) respondents experienced at least one alcohol-related hospitalization during the observation period. Moderate to excessive drinking was the strongest predictor of subsequent admission to hospital with an alcohol-related diagnosis, with clear evidence of a dose - response relationship. Moderate and heavy smoking were also significant predictors of subsequent admission to hospital with an alcohol-related problem. Social factors - such as being in receipt of income-related benefits [HR 1.68, 95% confidence interval (CI) 1.25-2.28]; being retired or economically inactive; and being separated, divorced or widowed (HR 2.34, 95% CI 1.70-3.22) - were also significant predictors of alcohol-related hospitalization.

Conclusions: Moderate and higher levels of weekly alcohol consumption, moderate to heavy smoking, economic circumstances and marital status are the main risk factors for alcohol-related hospitalization in the Scottish population. These findings add to the evidence that population-based strategies are needed to limit alcohol-related morbidity.