Data from: Tobacco stained fingers and its association with death and hospital admission: a retrospective cohort study

Background: Among smokers, the presence of tobacco stains on fingers has recently been associated with a high prevalence of tobacco related conditions and alcohol abuse. Objective: We aimed to explore tobacco stains as a marker of death and hospital readmission. Method: Seventy-three smokers presenting tobacco-tar staining on their fingers and 70 control smokers were followed during a median of 5.5 years in a retrospective cohort study. We used the Kaplan-Meier survival analysis and the log-rank test to compare mortality and hospital readmission rates among smokers with and smokers without tobacco stains. Multivariable Cox models were used to adjust for confounding factors: age, gender, pack-year unit smoked, cancer, harmful alcohol use and diabetes. The number of hospital admissions was compared through a negative binomial regression and adjusted for the follow-up time, diabetes, and alcohol use. Results: Forty-three patients with tobacco-stained fingers died compared to 26 control smokers (HR 1.6; 95%CI: 1.0 to 2.7; p 0.048). The association was not statistically significant after adjustment. Patients with tobacco-stained fingers needed a readmission earlier than smokers without stains (HR 2.1; 95%CI: 1.4 to 3.1; p<0.001), and more often (incidence rate ratio (IRR) 1.6; 95%CI: 1.1 to 2.1). Associations between stains and the first hospital readmission (HR 1.6; 95%CI: 1.0 to 2.5), and number of readmissions (IRR 1.5; 95%CI: 1.1 to 2.1) persisted after adjustment for confounding factors. Conclusions: Compared to other smokers, those presenting tobacco-stained fingers have a high unadjusted mortality rate and need early and frequent hospital readmission even when controlling for confounders.研究背景：在吸烟者群体中，手指出现烟草污渍这一表现近期被证实与烟草相关疾病及酒精滥用的高患病率存在显著关联。 研究目的：本研究旨在探索手指烟草污渍作为死亡与医院再入院风险标志物的应用价值。 研究方法：本研究为回顾性队列研究，共纳入73名存在手指焦油染色的吸烟者与70名对照吸烟者，中位随访时长为5.5年。我们采用Kaplan-Meier生存分析（Kaplan-Meier survival analysis）与log-rank检验（log-rank test），对比存在与无烟草污渍的吸烟者的死亡率及医院再入院率。采用多变量Cox比例风险模型（Multivariable Cox models）校正混杂因素，包括年龄、性别、吸烟包年数、癌症病史、有害饮酒史与糖尿病。通过负二项回归（negative binomial regression）比较住院总次数，并对随访时长、糖尿病及饮酒情况进行校正。 研究结果：43名存在手指烟草污渍的受试者死亡，而对照吸烟者中仅26名死亡（风险比HR=1.6；95%置信区间CI：1.0~2.7；P=0.048）。在校正混杂因素后，该关联不再具有统计学显著性。存在烟草污渍的受试者较无污渍吸烟者更早出现医院再入院（HR=2.1；95%CI：1.4~3.1；P<0.001），且再入院频率更高（发生率比IRR=1.6；95%CI：1.1~2.1）。在校正混杂因素后，烟草污渍与首次医院再入院（HR=1.6；95%CI：1.0~2.5）及再入院总次数（IRR=1.5；95%CI：1.1~2.1）之间的关联依然显著存在。 研究结论：与其他吸烟者相比，存在手指烟草污渍的受试者未校正死亡率更高，且即使在校正混杂因素后，仍需更早且更频繁地接受医院再入院治疗。