在患有慢性病的住院患者中使用阿片类药物和中毒
Nadim Zaidan1, Youssef Jalloul2, David S Goldfarb3
1Department of Medicine, Northwell Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY, 10305, USA. nzaidan@northwell.edu.
Journal of nephrology
|December 1, 2024
概括
慢性脏病 (CKD) 患者的阿片类药物使用显示了较低的不复杂使用与晚期CKD. 复杂的阿片类药物使用增加了较轻的CKD,阿片类药物中毒与复杂的使用有关,而不是CKD阶段.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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:
- 在功能受损,特别是慢性病 (CKD) 患者中,阿片类药物的使用和安全性是关键问题.
- 有限的文献存在于阿片类药物处方模式和慢性脏病不同阶段的并发症.
- 这项研究调查了住院CKD患者群体中的阿片类药物使用和中毒情况.
研究的目的:
- 分析慢性病各个阶段的住院患者的阿片类药物使用模式 (不复杂和复杂) 和阿片类药物中毒情况.
- 在CKD患者中确定与阿片类药物使用和中毒相关的因素.
- 为在功能障碍患者处方阿片类药物的安全指南提供信息.
主要方法:
- 从2016-2020年利用国家住院患者数据库 (NIS) 识别无并发症/并发症阿片类药物使用和阿片类药物中毒的CKD患者.
- 排除了接受替代疗法的末期病患者.
- 使用后勤回归分析,调整人口和社会经济因素,以CKD第一阶段为参考.
主要成果:
- 分析了2,917,404名CKD患者 (14,587,017个加权) 的队列.
- 不复杂的阿片类药物使用在晚期CKD阶段下降,而复杂的使用在较轻的CKD阶段增加.
- 在住院CKD患者中,阿片类药物的使用是中毒的主要预测因素,独立于CKD阶段.
结论:
- 处方者在晚期慢性脏病中对阿片类止痛药表示更加谨慎.
- 复杂的阿片类药物使用在大多数CKD阶段更为普遍.
- 慢性病患者的阿片类药物中毒主要是由复杂的阿片类药物使用驱动的,而不是病的严重程度.
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