MORTALITY-RATES AND PREDICTORS OF MORTALITY AMONG LATE MIDDLE-AGED AND OLDER SUBSTANCE-ABUSE PATIENTS

This study describes mortality rates and predictors of mortality among late-middle-aged and older (55+) substance abuse inpatients (n = 21,1 39) in Department of Veterans Affairs (VA) Medical Centers in the 4 ye ars after an index episode of care. A total of 24% of the patients die d; this mortality rate was 2.64 times higher than expected. Predictors of earlier mortality included older age end nonmarried status, alcoho l psychosis and organic brain disorder diagnoses, and several medical diagnoses, including neoplasms, liver cirrhosis, respiratory, endocrin e and metabolic, and blood system disorders. Three proxy indicators of illness severity also predicted mortality: more prior inpatient and o utpatient medical care and an index episode in an extended care unit. In contrast, more prior outpatient mental health care and remitted sta tus predicted lower mortality. These diagnostic and treatment indicato rs can be used to identify patients at heightened risk for premature m ortality. Moreover, they show that intensive mental health aftercare a nd remission of substance abuse may delay mortality, even among older patients who have longstanding substance abuse problems.