杨学智,陆冰,魏菀,曾真,胡思贵,曹永康,马贞玉.酒精使用障碍严重程度的影响因素及风险预测模型构建[J].四川精神卫生杂志,2024,37(2):131-136.Yang Xuezhi,Lu Bing,Wei Wan,Zeng Zhen,Hu Sigui,Cao Yongkang,Ma Zhenyu,Factors influencing the severity of alcohol use disorder and the construction of risk prediction model[J].SICHUAN MENTAL HEALTH,2024,37(2):131-136
Factors influencing the severity of alcohol use disorder and the construction of risk prediction model
DOI:10.11886/scjsws20231011003
English keywords:Alcohol use disorder  Disease severity  diagnostic trait  γ-Glutamyl transpeptidase  Total bilirubin
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Author NameAffiliationPostcode
Yang Xuezhi School of Public Health Guangxi Medical University Nanning 530021 China
Nanning Fifth People's Hospital Nanning 530001 China 
530001
Lu Bing Nanning Fifth People's Hospital Nanning 530001 China 530001
Wei Wan Nanning Fifth People's Hospital Nanning 530001 China 530001
Zeng Zhen Nanning Fifth People's Hospital Nanning 530001 China 530001
Hu Sigui Nanning Fifth People's Hospital Nanning 530001 China 530001
Cao Yongkang Nanning Fifth People's Hospital Nanning 530001 China 530001
Ma Zhenyu School of Public Health Guangxi Medical University Nanning 530021 China 530021
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      Background Alcohol use disorder (AUD) is a common chronic and relapsing psychiatric disorders. Identifying severe AUD early and intervening promptly is crucial to prevent irreversible harm. Currently, the assessment of AUD severity primarily relies on psychiatric examination by clinicians, and there is limited research on the factors influencing AUD severity and the development of prediction models.Objective To analyze the factors influencing AUD severity, and construct a risk prediction model to aid in the assessment of disease progression in AUD patients.Methods A retrospective analysis was conducted on 1 358 first-time hospitalized patients admitted to Nanning Fifth People's Hospital from January 1, 2017 to December 31, 2022. These patients met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for AUD. Basic patient data was collected, and the patients were divided into two groups based on disease severity: mild-moderate group (n=330) and severe group (n=1 028). The patients were randomly divided into training and test sets in a 7∶3 ratio. A Logistic regression model was constructed in the training set, and the predictive ability of the model for disease severity was evaluated using the receiver operating characteristic (ROC) curve in the test set.Results Compared with the mild-moderate group, the severe group had a higher proportion of patients living in urban areas (χ2=7.804), were farmers (χ2=17.991), had a higher frequency of alcohol consumption (more than 1 to 2 drinks/day) (χ2=35.267), had a higher age at first drinking (t=-3.858), had a greater number of comorbid somatic disorders (Z=-22.782), and had higher proportions of γ-Glutamyl transpeptidase (χ2=259.940) and total bilirubin abnormalities (χ2=148.552) (P<0.01). Logistic analysis conducted in the training set showed that being a farmer (OR=2.024, 95% CI: 1.352~3.029), having an older age at first drinking (OR=1.075, 95% CI: 1.025~1.129), drinking outside of mealtimes (OR=3.988, 95% CI: 2.408~6.606), having total bilirubin abnormalities (OR=1.034, 95% CI: 1.000~1.069), and having more comorbid somatic diseases (OR=4.386, 95% CI: 2.636~7.298) were identified as risk factors for disease severity in AUD patients. The area under curve (AUC) for this model in the test set was 0.906.Conclusion In psychiatric hospitals, being a farmer, having an older age at first drinking, drinking outside of mealtimes, having abnormal total bilirubin levels, and having comorbidities with somatic illnesses may be risk factors for severe AUD.
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