在创伤受伤的患者中,阿片类药物处方不平等
Sophia M Smith1,2, Rachel Adams1, Emily Ha1,2
1From the Department of Surgery, Boston Medical Center, Boston, MA (Smith, Adams, Saillant, Franks, Sanchez).
Journal of the American College of Surgeons
|February 11, 2025
概括
在创伤护理中处方阿片类药物显示了种族差异,非白人患者接受的剂量较低. 语言和并发症等因素影响了阿片类药物处方,突出了疼痛管理中的不平等.
科学领域:
- 创伤外科 手术 创伤外科
- 疼痛管理 疼痛管理
- 健康差异 在健康上的差异
背景情况:
- 创伤患者的阿片类药物处方模式尚未得到充分理解.
- 在创伤人群中,弱势群体的代表性不成比例.
- 这项研究调查了创伤伤害后阿片类药物管理中的差异.
研究的目的:
- 评估创伤患者在阿片类药物管理中的种族和民族差异.
- 确定影响阿片类药物处方模式的因素,在整个住院期间和出院时.
- 根据患者的人口统计和临床因素,检查毫克吗啡等价剂 (MMEs) 和疼痛控制日的差异.
主要方法:
- 在一级创伤中心对成年创伤患者 (2018-2021) 的回顾性队列研究.
- 片类药物的剂量量以毫克的吗啡等价物 (MMEs) 量化.
- 多变量回归模型分析了与阿片类药物接收,MME和疼痛控制日相关的因素.
主要成果:
- 非白人患者,包括黑人和西班牙裔患者,在住院治疗期间接受的MMEs显著较低.
- 与在出院时接受阿片类药物的几率较低相关的因素包括非英语语言,物质使用障碍,神经精神疾病并发症和暴力伤害.
- 黑人患者在出院时接受了较低的MMEs,而物质使用障碍患者的疼痛控制日数较少.
结论:
- 在整个住院期间,创伤患者在阿片类药物处方方面存在显著差异.
- 非白人患者接受了较低的阿片类药物剂量,这表明疼痛管理中的潜在不平等.
- 患者的语言,精神健康并发症和受伤机制影响了阿片类药物处方.
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