Gretchen E White1, Anita P Courcoulas2, Wendy C King3. 1. Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: whitege@upmc.edu. 2. Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 3. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Abstract
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. 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, 1 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.
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. 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, 1 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.
Authors: Meg H Zeller; Jennifer Reiter-Purtill; Todd M Jenkins; Katherine M Kidwell; Heather E Bensman; James E Mitchell; Anita P Courcoulas; Thomas H Inge; Sanita L Ley; Kathryn H Gordon; Eileen A Chaves; Gia A Washington; Heather M Austin; Dana L Rofey Journal: Surg Obes Relat Dis Date: 2019-12-24 Impact factor: 4.734
Authors: Scott G Engel; Lauren M Schaefer; Gail A Kerver; Lynnette M Leone; Greg Smith; James E Mitchell; John Gunstad; Ross D Crosby; Kristine Steffen Journal: Surg Obes Relat Dis Date: 2021-09-03 Impact factor: 4.734