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Pre-Operative Substance Use Disorder is Associated with Higher Risk of Long-Term Mortality Following Bariatric

Jaewhan Kim1, Joshua Kelley2, Sayeed Ikramuddin3

  • 1Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA. Jaewhan.kim@utah.edu.

Obesity Surgery
|April 3, 2023
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Summary

Patients with substance use disorders (SUD) before bariatric surgery face significantly higher long-term mortality risks. This includes increased risks from both internal and external causes of death following metabolic and bariatric surgery (MBS).

Keywords:
Bariatric SurgeryLong-term MortalityObesitySubstance Use Disorder

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Area of Science:

  • Medical research
  • Surgical outcomes
  • Public health

Background:

  • Metabolic and bariatric surgery (MBS) is linked to reduced mortality.
  • The impact of pre-operative substance use disorders (SUD) on long-term mortality after MBS is not well understood.

Purpose of the Study:

  • To assess the long-term mortality of patients with and without pre-operative SUD who underwent MBS.

Main Methods:

  • Utilized two statewide databases: Utah Bariatric Surgery Registry and Utah Population Database.
  • Linked MBS patients (1997-2018) to death records (1997-2021).
  • Employed Cox regression to analyze all-cause, internal, and external mortality risks associated with pre-operative SUD.

Main Results:

  • Patients with pre-operative SUD had a 2.47 times higher risk of all-cause mortality (HR=2.47, p<0.01).
  • Internal cause mortality was 129% higher (HR=2.29, p<0.01) and external cause mortality was 216% higher (HR=3.16, p<0.01) in patients with pre-operative SUD.

Conclusions:

  • Pre-operative SUD is associated with significantly increased hazards of all-cause, internal, and external cause mortality after bariatric surgery.