Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
Norwegian Institute of Public Health, Oslo, Norway.
Eur Addict Res. 2023;29(4):272-284. doi: 10.1159/000530822. Epub 2023 Jun 29.
Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender.
This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000-2019), Denmark (2000-2018), and Norway (2010-2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality.
In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark).
This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.
在接受当前或既往阿片类药物维持治疗（OMT）的人群中，导致过早死亡的主要原因是阿片类药物过量。然而，该人群的其他死亡原因仍然很高。了解多个环境下的死亡原因有助于提供更全面的预防应对措施。本研究旨在描述三个国家队列（捷克、丹麦和挪威）中 OMT 患者的所有非过量死亡原因，并探讨非过量死亡率与年龄和性别之间的关系。
这是一项前瞻性比较队列研究，使用了捷克（2000-2019 年）、丹麦（2000-2018 年）和挪威（2010-2019 年）的国家 OMT 患者死亡率登记数据库。根据特定原因死亡率计算了死亡率和年龄标准化死亡率（ASMR），即每 1000 人年的死亡人数。
共纳入 29486 名患者，记录到 5322 例死亡（18%）。我们发现队列之间以及性别和年龄组内的死亡原因存在差异。非过量死亡的主要原因是捷克和丹麦的意外事故，以及挪威的肿瘤。心血管疾病死亡在捷克最高，尤其是 OMT 女性（ASMR 为 3.59，挪威为 1.24，丹麦为 1.87）。
本研究发现，两性和所有年龄组的可预防死亡发生率都很高。不同的人口结构、风险暴露的变化以及编码实践的差异可以解释这些差异。这些发现支持在不同环境中针对 OMT 患者的人口统计学特征，加强对筛查和预防保健计划的努力。
