患有主要下肢截肢患者的阿片类药物使用障碍:流行率和结果
Luke T Pitsenbarger1, Natalie T Chao1, Allison S Karwoski1
1Department of Surgery, Vascular Division, University of Maryland School of Medicine, Baltimore, MD, USA.
The American surgeon
|December 4, 2023
概括
经过主要下肢截肢 (LEA) 的阿片类药物使用障碍 (OUD) 患者的再入院和再截肢率较低. 这项研究强调了OUD.
科学领域:
- 整形外科手术 整形外科手术
- 成 药物 药物 药物 药物
- 公共卫生 公共卫生
背景情况:
- 阿片类药物使用障碍 (OUD) 与术后并发症和死亡率的增加有关.
- 阿片类药物流行病对经历下肢切断 (LEA) 的患者的影响尚不清楚.
- 对OUD的LEA患者的结果需要进一步调查.
研究的目的:
- 为了确定在接受重大LEA的患者中OUD的患病率.
- 评估术前OUD与患者特征,并发症和术后结果之间的关联.
- 为了评估LEA患者具有和没有OUD的长期结果.
主要方法:
- 在2015-2021年期间,对689名接受重大LEA的患者进行了回顾性图表审查.
- 评估患者的人口统计,并发症和术后结果.
- 基于手术前OUD存在的结果分析.
主要成果:
- 19.3%的患者有手术前OUD的病史.
- OUD与年龄较小,黑人种族,单身状态,BMI较低,缺乏初级保健和医疗补助保险有关.
- OUD与目前的吸烟,艾滋病毒和骨髓炎史有关.
- 手术前的OUD独立地预测了较低的30-60天再录取率和1-12个月的再切除率.
- 没有观察到长期死亡率或随访的显著差异.
结论:
- 在接受重大LEA的患者中,OUD普遍存在.
- 手术前的OUD与特定的患者特征和并发症有关.
- OUD与有关再接收和再截肢的改善短期结果有关,这需要对潜在机制进行进一步的研究.
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