评估在骨折护理中服用口服止痛药后潜在的意外不良事件和死亡率 - - 一项队列研究
Zehra Abdul Muhammad1, Tashfeen Ahmad1,2, Haroon Rashid1
1Departments of Surgery, The Aga Khan University, Karachi, Pakistan.
Expert opinion on drug safety
|August 13, 2024
概括
某些口服止痛药的组合,特别是乙氨基与特拉马多尔以及其他药物,可能会增加患有骨骨折的老年患者的死亡风险. 仔细选择止痛药对于患者的安全和避免不良事件至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 药理学 药理学是指药理学的学科.
- 老年病的医生 老年病的医生
背景情况:
- 骨折手术后有效的疼痛管理是至关重要的.
- 个体患者的耐受性和风险因素会影响止痛药的选择.
- 目前的口服止痛方法及其安全性需要评估.
研究的目的:
- 为了评估口服止痛药的处方模式,骨折后手术.
- 确定与止痛药副作用和意外事件相关的因素.
- 评估创伤患者与口服止痛药相关的死亡率.
主要方法:
- 对198名患有近腰骨,脚和后脚骨折的患者进行前性队列研究.
- 在出院时处方的口服止痛药的分层分析和1周的随访.
- 2周的毒性评估,卡普兰-梅尔生存分析,以及与止痛药相关死亡的绝对风险计算.
主要成果:
- 62%的患者经历了不良事件. 7例死亡中有5例可能与乙氨基-特拉马多尔与其他止痛药的组合有关 (绝对风险为2.5%).
- 意外的严重不良事件发生在接受乙氨基-特拉马多尔或迪克洛芬雅克治疗的2%的患者中.
- 患有关节骨折的老年糖尿病和高血压患者面临更高的死亡或意外事件风险.
结论:
- 特定的口服止痛药组合 (乙氨基-特拉马多尔与普雷加巴林,迪克洛菲纳克,埃托里克西布或 gabapentin) 可能会增加老年人,糖尿病患者和患有骨折的高血压患者的风险.
- 这些发现强调了在风险人群中需要安全和个性化的止痛选择的必要性.
- 优化止痛策略对于减轻骨折手术后不良结果至关重要.
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