title: Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis.
abstract: BACKGROUND
  Alcohol dependence (AD) carries a high mortality burden, which may be mitigated by reduced alcohol consumption. We conducted a systematic literature review and meta-analysis investigating the risk of all-cause mortality in alcohol-dependent subjects.
  
  
  METHODS
  MEDLINE, MEDLINE In-Process, Embase and PsycINFO were searched from database conception through 26th June 2014. Eligible studies reported all-cause mortality in both alcohol-dependent subjects and a comparator population of interest. Two individuals independently reviewed studies. Of 4540 records identified, 39 observational studies were included in meta-analyses.
  
  
  RESULTS
  We identified a significant increase in mortality for alcohol-dependent subjects compared with the general population (27 studies; relative risk [RR] = 3.45; 95% CI [2.96, 4.02]; p < 0.0001). The mortality increase was also significant compared to subjects qualifying for a diagnosis of alcohol abuse or subjects without alcohol use disorders (AUDs). Alcohol-dependent subjects continuing to drink heavily had significantly greater mortality than alcohol-dependent subjects who reduced alcohol intake, even if abstainers were excluded (p < 0.05).
  
  
  CONCLUSIONS
  AD was found to significantly increase an individual's risk of all-cause mortality. While abstinence in alcohol-dependent subjects led to greater mortality reduction than non-abstinence, this study suggests that alcohol-dependent subjects can significantly reduce their mortality risk by reducing alcohol consumption.
authors.affiliation: Université Claude Bernard Lyon I, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France ; Lundbeck SAS, 37-45, Quai du Président Roosevelt, Issy-les-Moulineaux, 92445 Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Laramée
authors.affiliation: Costello Medical Consulting, City House, 126-130 Hills Road, Cambridge, CB2 1RE, UK.
authors.forename: Saoirse
authors.initials: S
authors.lastname: Leonard
authors.affiliation: Costello Medical Consulting, City House, 126-130 Hills Road, Cambridge, CB2 1RE, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Buchanan-Hughes
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, CB1 8RN, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Warnakula
authors.affiliation: University Alcohol Treatment Centre, Lausanne University Hospital, Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Daeppen
authors.affiliation: Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada ; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada ; Klinische Psychologie und Psychotherapie, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000401:mortality; D000437:Alcoholism / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D006801:Humans; D016017:Odds Ratio; D012306:Risk
keywords: Abstinence; Alcohol dependence; Alcoholism; Meta-analysis; Mortality; Systematic review