切除术后持续使用阿片类药物的预测因素:来自英格兰的基于人口的队列研究
R M Baamer1,2, D J Humes3, L S Toh1
1Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK.
Anaesthesia
|June 2, 2023
概括
切除术后使用阿片类药物很常见,特别是在之前接触过阿片类药物的患者中. 微创手术可能会减少持续的术后阿片类药物使用.
科学领域:
- 手术 手术 手术 术 术
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 术后持续使用阿片类药物在切除术后越来越令人担忧.
- 了解预测因素对于开发有针对性的干预措施至关重要.
研究的目的:
- 为了确定术后持续使用阿片类药物的患病率.
- 为了确定持续使用阿片类药物的预测因素,按入院前阿片类药物暴露分层.
主要方法:
- 使用链接的初级和二级护理数据 (2010-2019) 进行了回顾性队列研究.
- 对93,262名成年大肠切除术患者的分析,按入院前阿片类药物暴露分类.
- 多变量后勤回归以确定持续阿片类药物使用的预测因素 (定义为在出院后90天和91-180天内处方阿片类药物).
主要成果:
- 8.1%的患者出现了持续的术后阿片类药物使用.
- 手术前的阿片类药物暴露显著增加了持续使用 (40.4%的目前暴露与2.5%的阿片类药物-naive).
- 长期使用阿片类药物配方,高贫困,并发病,白人种族,开放性手术和以前的阿片类药物暴露是预测因素. 最少侵入性手术与更低的几率有关.
结论:
- 手术前的阿片类药物暴露是切除术后持续的术后阿片类药物使用的主要风险因素.
- 最少侵入性的手术方法可以减轻持续使用阿片类药物的风险.
- 识别和解决可修改的风险因素,如外科手术方法是必不可少的.
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