在接受重大手术后患有行为健康障碍的患者中,新的持续性阿片类药物使用
Zayed Rashid1, Amanda B Macedo2, Selamawit Woldesenbet3
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH. Electronic address: https://twitter.com/ZRashidMD.
Surgery
|March 8, 2025
概括
患有行为健康障碍并接受重大手术的患者面临更高的风险发展持续的阿片类药物使用. 这凸显了这一群体需要谨慎的疼痛管理策略的需要.
科学领域:
- 手术 手术 手术
- 疼痛管理 疼痛管理
- 行为健康 行为健康
背景情况:
- 吸毒或精神疾病患者对术后疼痛的反应可能不同.
- 这种不同的反应可能会导致阿片类药物使用率增加.
- 行为健康障碍 (BHD) 涵盖了物质使用,饮食/睡眠以及心理健康状况.
研究的目的:
- 调查行为健康障碍与重大外科手术后新的持续阿片类药物使用之间的关联.
- 量化患有先前存在BHD的患者新持续性阿片类药物使用的风险.
主要方法:
- 一项使用IBM-MarketScan数据库 (2013-2020) 的回顾性队列研究.
- 确定了接受重大手术的患者,并根据先前存在的BHDs进行分类.
- 定义新的持续性阿片类药物使用为阿片类药物未使用患者手术后3-6个月内进行两次随后的补充.
- 利用多变量回归来分析BHD与持续使用阿片类药物之间的关联.
主要成果:
- 这项研究包括了62585名患者;23.9%的患者有先前存在的BHD.
- 新的持续性阿片类药物使用发生在17.5%的术后阿片类药物使用患者中.
- 患有BHD的患者出现了较高的新持续性阿片类药物使用率 (20.3%对比16.6%) 和较高的中位数阿片类药物剂量.
- BHD与32%的新持续阿片类药物使用率增加有关 (OR: 1.32,95%CI: 1.21-1.44).
结论:
- 大约五分之一的经过重大手术的BHD患者出现了新的持续性阿片类药物使用.
- 以前存在的行为健康障碍显著增加了重大手术后新的持续阿片类药物使用的风险.
- 这些发现强调了在手术患者护理中解决BHD的重要性,以减轻与阿片类药物相关的风险.
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