代谢和减重手术（MBS）已被认为与降低全因死亡率相关。虽然手术前有物质使用障碍 (SUD) 的受试者数量已被记录，但手术前 SUD 对进行 MBS 后的长期死亡率的影响尚不清楚。本研究评估了接受 MBS 的手术前和手术后没有 SUD 的患者和有 SUD 的患者的长期死亡率。该研究使用了两个全州数据库：犹他州肥胖外科手术登记簿 (UBSR) 和犹他州人口数据库。在 1997 年至 2018 年间接受 MBS 的受试者的死亡记录（1997-2021 年）被链接，以确定手术后的死亡和死亡原因。研究的主要结果为所有死亡（内部、外部和未知原因）、内部死亡和外部死亡。外部死亡的原因包括意外伤害、毒药中毒和自杀。内部死亡的原因包括与自然原因有关的死亡，例如心脏病、癌症和感染。总共有 17,215 名患者被纳入分析中。使用 Cox 回归估计与手术前 SUD 相关的可控协变量的危险比率（HR）。手术前有 SUD 的受试者死亡风险是没有 SUD 的患者的 2.47 倍 (HR = 2.47，p＜0.01)。那些手术前有 SUD 的人的内部死亡原因比没有 SUD 的人高了 129％ (HR = 2.29，p＜0.01)，外部死亡风险比没有手术前 SUD 的人高了 216％ (HR = 3.16，p＜0.01)。手术前 SUD 与接受减肥手术的患者的所有因素、内部因素和外部因素死亡率的危险性更高。©2023年作者，独家许可 Springer Science+Business Media, LLC，属于 Springer Nature。

Metabolic and bariatric surgery (MBS) has been associated with reduced all-cause mortality. While the number of subjects with substance use disorders (SUD) before MBS has been documented, the impact of pre-operative SUD on long-term mortality following MBS is unknown. This study assessed long-term mortality of patients with and without pre-operative SUD who underwent MBS.Two statewide databases were used for this study: Utah Bariatric Surgery Registry (UBSR) and the Utah Population Database. Subjects who underwent MBS between 1997 and 2018 were linked to death records (1997-2021) to identify any death and cause for death following MBS. All deaths (internal, external, and unknown reasons), internal deaths, and external deaths were the primary outcomes of the study. External causes of death included death from injury, poisoning, and suicide. Internal causes of death included deaths that were associated with natural causes such as heart disease, cancer, and infections. A total of 17,215 patients were included in the analysis. Cox regression was used to estimate hazard ratios (HR) of controlled covariates, including the pre-operative SUD.The subjects with pre-operative SUD had a 2.47 times higher risk of death as compared to those without SUD (HR = 2.47, p < 0.01). Those with pre-operative SUD had a higher internal cause of death than those without SUD by 129% (HR = 2.29, p < 0.01) and 216% higher external mortality risk than those without pre-operative SUD (HR = 3.16, p < 0.01).Pre-operative SUD was associated with higher hazards of all-cause, internal cause, and external cause mortality in patients who undergo bariatric surgery.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.