脆弱状态,不仅仅是年龄,与术后阿片类药物消费有关:以人口为基础的回顾性分析
Kyle R Latack1, Ryan Howard2,3,4, Mark C Bicket3,5
1From the Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
概括
虚弱状态与接受常见手术的患者的术后阿片类药物使用率较高有关. 这一发现表明,在阿片类药物处方指南和结果研究中应考虑脆弱性.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 疼痛管理 疼痛管理
背景情况:
- 生理储备是手术恢复的关键因素,根据年龄和脆弱性进行评估.
- 虽然年龄较大可能与较低的阿片类药物需求相关,但虚弱状态是术后阿片类药物消费的一个明显的,研究不足的预测因素.
- 了解虚弱的影响对于优化疼痛管理和患者的结果至关重要.
研究的目的:
- 调查虚弱状态和术后阿片类药物消费之间的关联.
- 为了确定脆弱是否会影响阿片类药物需求,而不依赖于年龄.
- 为未来的疼痛管理策略和结果分析提供信息.
主要方法:
- 对34,854名未使用过阿片类药物的成年患者进行回顾性分析,这些患者接受了常见的外科手术手术 (2017年11月 - 2021年2月).
- 使用修改后的脆弱指数 (mFi-5) 评估的脆弱性.
- 主要结局:患者报告的30天阿片类药物消耗 (口服吗啡等价剂 - OME);通过线性回归分析,按年龄分层.
主要成果:
- 修改过的虚弱指数得分>1的患者报告了显著更高的阿片类药物消费 (3.3 OME大;95% CI = 1.5-5.1).
- 这种关联在65岁以上的患者中持续存在 (2.7 OME大;95% CI = 0.2-5.1).
- 矛盾的是,较高的虚弱状态与较小的阿片类药物处方有关.
结论:
- 虚弱状态是普通外科手术后阿片类药物消费增加的重要预测因素.
- 将脆弱性评估纳入临床实践可以改进阿片类药物处方并改善患者的治疗结果.
- 未来的研究应该将脆弱性视为分析阿片类药物使用和不良事件的关键因素.
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