title: Mortality and cause of death in a cohort of people who had ever injected drugs in Glasgow: 1982-2012.
abstract: BACKGROUND
  To describe all-cause and cause-specific mortality in a cohort of people who had ever injected drugs (PWID) with a low prevalence of HIV over 20-30 years.
  
  
  METHODS
  Using a retrospective study design, identifying data from a cohort of PWID recruited between 1982 and 1993 through in-patient drug treatment services were linked to National Records for Scotland deaths data using probabilistic record linkage. We report all-cause and cause-specific mortality rates; standardized mortality ratios (SMR) across time, gender and age were estimated.
  
  
  RESULTS
  Among 456 PWID, 139 (30.5%) died over 9024 person-years (PY) of follow-up. Mortality within the cohort was almost nine times higher than the general population, and remained elevated across all age groups. The greatest excess mortality rate was in the youngest age group, who were 15-24 years of age (SMR 31.6, 95% CI 21.2-47.1). Drug-related deaths declined over time and mortality was significantly higher among HIV positive participants. Although SMRs declined with follow-up, the SMR of the oldest age group (45-60) was 4.5 (95% CI 3.0-6.9). There were no significant differences in all-cause mortality rates between participants who were 25 years and older at cohort entry compared to younger participants.
  
  
  CONCLUSIONS
  Mortality rates remained higher than the general population across all age groups. Screening services that identify a history of injecting drug use may be an opportunity to address risk factors faced by an ageing population of PWID and potentially have implications for future health care planning.
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: dhanya@burnet.edu.au.
authors.forename: Dhanya
authors.initials: D
authors.lastname: Nambiar
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK; Health Protection Scotland, Glasgow, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Weir
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK; Health Protection Scotland, Glasgow, UK.
authors.forename: Esther J
authors.initials: EJ
authors.lastname: Aspinall
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Stoové
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK; Health Protection Scotland, Glasgow, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hutchinson
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Dietze
authors.affiliation: Information Services Division, Glasgow, UK.
authors.forename: Lynsey
authors.initials: L
authors.lastname: Waugh
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Scotland, UK; Health Protection Scotland, Glasgow, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006556:Heroin Dependence / Q000401:mortality; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000401:mortality*; D055815:Young Adult
keywords: Age; Cohort; Mortality; PWID; SMR