紧急部门阿片类药物处方对健康结果的影响
Jake Hayward1, Rhonda J Rosychuk1, Andrew D McRae1
1Department of Emergency Medicine (Hayward), University of Alberta; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Departments of Emergency Medicine and Community Health Sciences (McRae, Innes), University of Calgary, Calgary, Alta.; Department of Medicine (Sinnarajah), Queen's University, Kingston, Ont.; Department of Emergency Medicine, Faculty of Medicine & Dentistry (Dong), University of Alberta, Edmonton, Alta.; Hotchkiss Brain Institute of Psychiatry, Psychology and Neuroscience (Tanguay), University of Calgary; Department of Family Medicine (Montgomery), University of Calgary, Calgary, Alta.; Alberta Health Services (Huang), Edmonton, Alta.
紧急部门的阿片类药物处方稍微增加了住院和长期使用阿片类药物,特别是在老年,男性和阿片类药物无知的患者中. 过量服用,新的阿片类药物治疗或死亡的风险并没有增加.
科学领域:
- 紧急医疗 紧急医疗
- 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:
- 急诊室 (ED) 处方阿片类药物和患者伤害之间的联系是复杂的,研究不足.
- 在ED阿片类药物处方后量化不良结果和长期使用阿片类药物至关重要.
研究的目的:
- 为了评估接受阿片类药物处方的ED患者的不良结果,增加风险和长期使用阿片类药物.
- 为了比较接受阿片类药物和倾向匹配对照组的患者之间的结果.
主要方法:
- 使用了来自阿尔伯塔州ED10年访问的行政数据,不包括特定的患者群体.
- 倾向性得分匹配被用来比较那些在72小时内填写阿片类药物处方的患者与未经治疗的对照.
- 主要结局是与阿片类药物相关的ED访问,新的阿片类药物激动剂治疗,住院治疗或在一年内死亡的组合.
主要成果:
- 吸食阿片类药物的人患主要组合结局的比例高出1.4%,主要是由于住院和长期使用阿片类药物.
- 没有观察到与阿片类药物相关的ED访问,新的阿片类药物激动剂治疗或死亡率的显著增加.
- 患有精神健康或物质使用情况的患者的增量风险最低,而未服用阿片类药物的患者,老年人和男性的增量风险最高.
结论:
- ED阿片类药物处方与随后的阿片类药物使用和住院病人的适度增加有关.
- 特定的患者人口统计学 (老年人,男性,阿片类药物素朴) 面临更高的增量风险.
- 医生在为急性疼痛开处方阿片类药物时,应考虑患者特定的风险.
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