手术前的阿片类药物依赖与增加的成本和脚关节整形术后的伤口消失有关
Weston E McDonald1, Alexander S Guareschi1, Joshua L Morningstar1
1Medical University of South Carolina, Department of Orthopaedics and Physical Medicine, CSB 708, MSC 622, 96 Jonathan Lucas Street, Charleston, SC 29425, United States.
概括
手术前阿片类药物依赖的患者面临更高的并发症风险,延长住院时间,并在全脚关节整形术 (TAA) 后增加成本. 这项研究强调了阿片类药物使用对TAA结果的影响.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 健康 结果 研究 研究 结果
背景情况:
- 慢性阿片类药物依赖是外科人员日益关注的问题.
- 了解其对选择性手术的影响,如全关节整形术 (TAA),对于患者的护理至关重要.
- 阿片类药物使用可能会影响手术结果和医疗保健资源利用.
研究的目的:
- 评估慢性阿片类药物依赖对手术后结局的影响,主要是关节整形手术 (TAA).
- 在TAA患者中确定与手术前阿片类药物使用相关的特定并发症和成本影响.
主要方法:
- 从2016年到2020年使用全国再接收数据库 (NRD) 进行回顾性队列研究.
- 确定了29751名接受初级选择性TAA的患者,其中861名 (2.9%) 患有手术前阿片类药物依赖.
- 统计分析以比较阿片类药物依赖和非依赖队列之间的结果.
主要成果:
- 手术前的阿片类药物依赖是增加伤口脱光风险的重要预测因素 (OR=5.365).
- 阿片类药物依赖与不良出院 (OR=1.443) 和延长停留时间 (LOS) >4天 (OR=1.438) 相关.
- 在阿片类药物依赖患者 (β=1052.27) 中,总入院费用 (>1000美元) 显著增加.
结论:
- 慢性手术前阿片类药物使用显著预测TAA后手术后并发症的比率更高.
- 阿片类药物依赖与延长停留时间和TAA的实质性更高的入学费用有关.
- 这些发现强调了在接受TAA的患者中解决手术前阿片类药物使用的重要性.
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