与眼科手术有关的阿片类药物处方后的住院治疗,过量服用和死亡率
Viengneesee Thao1, David A Helfinstine1, Lindsey R Sangaralingham1
1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
Ophthalmology
|January 27, 2024
概括
眼科手术后的阿片类药物处方显著增加了死亡,住院,过量服用和依赖的风险. 较高的阿片类药物剂量与更大的不良结果相关,强调需要谨慎的处方做法.
科学领域:
- 眼科医生 眼科 眼科
- 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:
- 处方阿片类药物带有相当大的系统性风险,即使是在眼科手术后.
- 了解这些风险对于患者安全和明智的临床决策至关重要.
研究的目的:
- 调查视科手术后阿片类药物处方与关键不良结果之间的关联.
- 具体地检查了与术后住院,阿片类药物过量服用,阿片类药物依赖和全因死亡率的联系.
主要方法:
- 追溯性,对被取消身份的行政索赔数据进行横截面分析.
- 利用倾向性得分匹配来创建可比的患者队列,这些患者接受和没有接受阿片类药物处方.
- 分析了三个队列:匹配的阿片类药物与非阿片类药物使用者,阿片类药物使用者,和分层的吗啡毫克相当 (MME) 组.
主要成果:
- 在1,577,692名眼科手术患者中,有20%填写了阿片类药物处方.
- 处方阿片类药物与增加的死亡率 (HR 1.28),住院 (HR 1.51),过量服用 (HR 7.31) 和依赖 (HR 13.05) 相关.
- 较高的MME剂量表明,死亡率,住院和滥用/依赖率的剂量依赖性增加.
结论:
- 眼科手术后接受阿片类药物处方的患者面临的死亡率,住院,过量服用和依赖率显著增加.
- 这些发现强调了在眼科手术后最大限度地减少阿片类药物使用的必要性.
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