Drug- and alcohol-related mortality risk after bariatric surgery: evidence from a 7-year prospective multicenter cohort study
Drug- and alcohol-related mortality risk after bariatric surgery: evidence from a 7-year prospective multicenter cohort study
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DOI：
10.1016/j.soard.2019.04.007
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发表时间：
2019-07-01
影响因子：
3.1
通讯作者：
King, Wendy C.
中科院分区：
文献类型：
--
作者：
White, Gretchen E.;Courcoulas, Anita P.;King, Wendy C.
背景资料：目前尚不清楚减肥手术是否会影响药物和酒精相关死亡率的风险。目的：比较观察到的药物和酒精相关死亡率与年龄、性别、种族和美国普通人群的年调整率。设置：减肥手术的纵向评估-2，2006年4月至2009年4月在美国10家医院接受减肥手术的2458名成年人的前瞻性队列研究。参与者参加了长达7年的术前和术后年度评估。药物和酒精相关的标准化死亡率（SMR）比较了观察到的减肥手术后死亡率与年龄、性别、种族和美国普通人群、整个队列和接受Roux-en-Y胃旁路术（RYGB）的人群的年调整预期死亡率。10起与吸毒或酗酒有关的死亡（6例意外用药过量，1例故意用药过量，1例故意未知用药过量和2例酒精性肝病）发生在15，616人-年的随访中，所有参与者均接受RYGB（n = 1770）。观察到的死亡率显著高于所有药物和酒精相关原因的预期（SMR = 2.10，95%置信区间= 1.01-3.86，P = 0.03）和接受RYGB的参与者（SMR = 2.90，95%置信区间= 1.39-5.33，P = 0.003）。RYGB SMR对于所有用药过量（P = .002）和意外用药过量（P = .01）均显着，并且方向相同，但对于故意用药过量、故意未知用药过量和酒精性肝脏疾病（P均>=. 05）.结论：药物和酒精相关的死亡率显着高于预期的减肥手术后7年，特别是RYGB后。(C)2019年美国肥胖外科学会。爱思唯尔公司出版All rights reserved.
Background: It is unclear whether bariatric surgery affects the risk of drug- and alcohol-related mortality.Objectives: To compare the observed drug- and alcohol-related mortality rate with age, sex, race, and year-adjusted rates from the general U.S. population.Setting: The Longitudinal Assessment of Bariatric Surgery-2, a prospective cohort study of 2458 adults who underwent bariatric surgery at 10 U.S. hospitals between April 2006 and April 2009.Methods: Participants attended presurgery and annual postsurgery assessments for up to 7 years. Drug- and alcohol-related standardized mortality ratios (SMR) comparing the observed post-bariatric surgery mortality rate with the age, sex, race, and year-adjusted expected mortality rate from the general U.S. population, among the entire cohort, and among those who underwent Roux-en-Y gastric bypass (RYGB).Results: Ten deaths related to drug or alcohol use (6 accidental overdose, 1 intentional overdose, intent unknown overdose, and 2 alcoholic liver disease) occurred across 15,616 person-years of follow-up, all among participants who underwent RYGB (n = 1770). The observed mortality rate was significantly higher than expected for all drug- and alcohol-related causes overall (SMR = 2.10, 95% confidence interval = 1.01-3.86, P = .03) and among participants who underwent RYGB (SMR = 2.90, 95% confidence interval = 1.39-5.33, P = .003). The RYGB SMRs were significant for all overdoses (P = .002) and accidental overdoses (P = .01) and in the same direction but nonsignificant for intentional overdoses, intent unknown overdoses, and alcoholic liver disease (P for all >=. 05).Conclusions: Drug- and alcohol-related mortality is significantly higher than expected in the 7 years after bariatric surgery, specifically after RYGB. (C) 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.