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患有急性严重性结肠炎住院患者的阿片类药物使用和结果
Norah Karlovich1, Ryan McConnell2, Fernando Velayos3
1Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Inflammatory bowel diseases
|September 19, 2024
概括
在急性严重性结肠炎 (ASUC) 住院期间使用大量阿片类药物会延迟生物治疗,并增加离院阿片类药物处方. 阿片类药物的使用没有影响停留时间或胆管切除率.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在住院的炎症性肠病患者中使用阿片类药物并未被证明可以改善疼痛或减少住院时间.
- 高剂量阿片类药物使用对急性严重性结肠炎 (ASUC) 临床结果的影响仍未得到充分研究.
研究的目的:
- 调查高阿片类药物使用与ASUC住院患者的临床结果之间的关联.
- 为了确定高阿片类药物消费是否影响生物救援疗法启动,切除术率或住院时间.
主要方法:
- 一项单中心研究分析了185例ASUC住院患者 (2014年7月至2021年12月) 接受静脉注射皮质类固醇.
- 收集的数据包括阿片类药物暴露 (≥40口服吗啡相当剂/天被定义为高使用量),皮质类固醇剂量,生物疗法,切除术,离院阿片类药物,停留时间和成本.
- 统变逻辑回归评估了高阿片类药物使用和ASUC结果之间的关系.
主要成果:
- 在11%的患者中观察到高水平的阿片类药物使用 (≥40个OMEs/天),并且与开始生物救援治疗的中位数3天的延迟有关 (P=.02).
- 高度使用阿片类药物的患者在出院时接受阿片类药物处方的比例明显更高 (70%与10%,P<.001).
- 在高阿片类药物使用量和停留时间,皮质类固醇持续时间,切除术率或住院费用之间没有发现显著的关联.
结论:
- 在ASUC住院治疗中,高水平的阿片类药物使用与延迟启动关键的生物救援疗法有关.
- 高水平的阿片类药物消费与阿片类药物处方患者出院的可能性增加有关.
- 这些发现凸显了ASUC管理中高阿片类药物利用的潜在风险.
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