认知状态与老年人手术后阿片类药物处方的关联
Christina L Shabet1, Mark C Bicket2,3, Emilie Blair4
1From the Department of Surgery, University of Michigan Medical School, University of Michigan, Ann Arbor.
概括
与正常认知或轻度认知障碍患者相比,患有痴呆症的患者在手术后接受的阿片类药物处方较少和较小. 认知状态影响术后疼痛管理策略.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 衰老与认知变化有关,影响医疗保健需求.
- 阿片类药物的使用在手术后是常见的,但认知状态的处方模式未得到充分研究.
研究的目的:
- 根据认知状态,研究接受选择性手术的老年人中阿片类药物处方的变化.
- 分析与认知功能相关的阿片类药物的初始填充,补充和处方数量的差异.
主要方法:
- 从健康和退休研究 (HRS) 中对65岁以上的医疗保险受益人的回顾性分析.
- 将HRS认知评估与2007-2016年间手术的Medicare索赔数据联系起来.
- 分类认知状态为正常,轻度认知障碍 (MCI) 或痴呆症;分析了阿片类药物填充率和数量.
主要成果:
- 与正常认知 (58.1%) 和MCI (54.5%) 相比,痴呆患者最初的阿片类药物处方填充率较低 (33.5%).
- 在认知群体中,阿片类药物补充率相似 (痴呆21%,正常24.1%,MCI 26.5%).
- 患有痴呆症的患者在出院后接受了明显较小的阿片类药物处方剂量,无论是以前使用过的患者还是未使用阿片类药物的患者.
结论:
- 痴呆症与接受手术后阿片类药物处方的可能性降低和分发量较小有关.
- 认知评估可以帮助外科医生量身定制个性化的术后疼痛管理计划.
- 这些发现强调了在手术患者的阿片类药物管理中需要考虑认知状态的必要性.
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