创伤后持续长期使用阿片类药物:发生率和危险因素
Matthew V Benns1, Jeremy T Gaskins, Keith R Miller
1From the Department of Bioinformatics and Biostatistics (J.T.G.); and Department of Surgery (M.V.B., K.R.M., N.A.N., M.C.B., S.J.P., G.R.M., J.J.C., B.G.H.), University of Louisville School of Medicine, Louisville, Kentucky.
The journal of trauma and acute care surgery
|October 24, 2023
概括
创伤前的阿片类药物使用显著预测了受伤后的长期使用. 对于未使用过阿片类药物的患者来说,持续的长期阿片类药物使用是罕见的,并且很难预测.
科学领域:
- 创伤外科 手术 创伤外科
- 疼痛管理 疼痛管理
- 流行病学 流行病学
背景情况:
- 美国面临严重的阿片类药物流行,创伤患者由于受伤后疼痛管理而面临阿片类药物依赖的高风险.
- 了解受伤前的阿片类药物使用对于识别患有创伤后长期阿片类药物依赖风险的患者至关重要.
研究的目的:
- 确定在创伤伤害之前和之后使用阿片类药物的流行率.
- 确定与创伤患者持续长期使用阿片类药物相关的风险因素.
主要方法:
- 在一年内,对2992名入院于一级创伤中心的患者进行了分析.
- 利用处方药监测计划数据追踪受控物质处方从受伤前6个月到出院后12个月.
- 长期持续使用者定义为那些在出院一年后接受麻醉剂的人.
主要成果:
- 20.4%的患者在受伤前已经填写了麻醉剂处方;12.5%的患者在创伤后持续长期使用阿片类药物.
- 在受伤前使用阿片类药物是持续长期使用的最强预测因素.
- 其他风险因素包括女性性别,更长的住院时间,更高的伤害严重性得分以及特定的伤害/手术.
结论:
- 在正在进行的阿片类药物流行病中,建议在创伤患者处方阿片类药物时谨慎.
- 在未曾服用过阿片类药物的创伤患者中,持续长期使用阿片类药物并不常见,并且难以预测.
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