Mortality and Causes of Death among Individuals in a National Opioid Agonist Treatment Cohort.

IF 1.8 3区医学 Q2 PSYCHIATRY

European Addiction Research Pub Date : 2026-10-15 DOI:10.1159/ear/acrag005

Tanja Schwarz, Judith Anzenberger, Martin Busch, Eva S Schernhammer, Susanne Strohmaier

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引用次数: 0

Abstract

Introduction: People with opioid use disorder experience markedly elevated all-cause and cause-specific mortality. Opioid-agonist treatment (OAT) reduces mortality risk, and OAT populations across Europe are ageing, with cardiovascular, respiratory, and liver diseases accounting for a growing proportion of deaths. However, cause-specific mortality beyond overdose remains poorly characterized in large national cohorts.

Methods: We conducted a retrospective cohort study including all 26,031 individuals (76% men) recorded in the Austrian national OAT registry between January 1, 2002, and December 31, 2019, linked to the national causes of death registry with follow-up through December 31, 2021. We calculated sex-specific age-standardized mortality rates per 100,000 person-years (2013 European Standard Population), standardized rate ratios (SRRs), and cause-specific standardized mortality ratios (SMRs) compared with the Austrian general population.

Results: Across 278,959 person-years of follow-up, 2,358 deaths occurred. Cohort members had substantially higher mortality across all causes, with greater excess among women (SRR 7.06, 95% CI 6.45-7.72) than men (3.86; 3.69-4.04). Beyond substance use-related causes (SMR 33.2, 95% CI 31.4-35.2), the highest SMRs were found for viral hepatitis (63.8, 52.3-77.8), HIV (48.6, 39.0-60.6), and valvular heart diseases and endocarditis (28.4, 18.6-43.6). By the early to mid-40s, deaths from non-communicable diseases collectively exceeded those from substance use-related causes.

Conclusion: Austria's national OAT cohort experiences substantial excess mortality across all major causes, with high relative excess for substance use-related, infectious, and liver-related conditions. As OAT populations age, non-communicable diseases account for an increasing share of deaths. Future analyses linking the cohort to additional data sources will be needed to disentangle the underlying contributions to this excess mortality.

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国家阿片类激动剂治疗队列中个体的死亡率和死亡原因。

背景：阿片类药物使用障碍患者的全因死亡率和特定原因死亡率明显升高。阿片类激动剂治疗（OAT）降低了死亡风险，整个欧洲的OAT人群正在老龄化，心血管、呼吸和肝脏疾病占死亡人数的比例越来越大。然而，在大型国家队列中，除过量用药外的死因特异性死亡率的特征仍然很差。方法：我们进行了一项回顾性队列研究，包括2002年1月1日至2019年12月31日期间奥地利国家OAT登记处记录的所有26,031人（76%为男性），与国家死亡原因登记处相关，随访至2021年12月31日。与奥地利普通人群相比，我们计算了每10万人年的性别特定年龄标准化死亡率（2013年欧洲标准人口）、标准化死亡率比（SRR）和原因特定标准化死亡率（SMR）。结果在278,959人年的随访中，发生了2,358例死亡。队列成员的死亡率在所有原因中都要高得多，女性的死亡率（SRR 7.06, 95% CI 6.45-7.72）高于男性（3.86;3.69-4.04）。除了药物使用相关的原因（SMR为33.2,95% CI为31.4-35.2），SMR最高的是病毒性肝炎（63.8,52.3-77.8）、HIV（48.6, 39.0-60.6）、瓣膜性心脏病和心内膜炎（28.4,18.6-43.6）。到40岁出头至45岁中期，非传染性疾病造成的死亡人数总和超过了与药物使用有关的死亡人数。奥地利的国家OAT队列在所有主要原因中都经历了大量的超额死亡率，与物质使用相关的、传染性的和肝脏相关的疾病的相对超额死亡率较高。随着OAT人口的老龄化，非传染性疾病在死亡人数中所占比例越来越大。未来的分析需要将该队列与其他数据来源联系起来，以理清造成这种高死亡率的潜在因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Addiction Research SUBSTANCE ABUSE-PSYCHIATRY

CiteScore

6.80

自引率

5.10%

发文量

审稿时长

>12 weeks

期刊介绍： ''European Addiction Research'' is a unique international scientific journal for the rapid publication of innovative research covering all aspects of addiction and related disorders. Representing an interdisciplinary forum for the exchange of recent data and expert opinion, it reflects the importance of a comprehensive approach to resolve the problems of substance abuse and addiction in Europe. Coverage ranges from clinical and research advances in the fields of psychiatry, biology, pharmacology and epidemiology to social, and legal implications of policy decisions. The goal is to facilitate open discussion among those interested in the scientific and clinical aspects of prevention, diagnosis and therapy as well as dealing with legal issues. An excellent range of original papers makes ‘European Addiction Research’ the forum of choice for all.