肺移植前阿片类药物使用与移植后阿片类药物使用和结果的关联
Jessica M Ruck1, Camille Hage1, Tao Liang1
1Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
Annals of thoracic surgery short reports
|March 18, 2025
概括
手术前使用阿片类药物显著增加了肺移植后使用阿片类药物的风险,死亡率和并发症. 减少手术前的阿片类药物使用可能会改善肺移植接受者的结果.
科学领域:
- 移植研究 移植研究
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在手术前使用阿片类药物 (OU) 是各种外科领域不良结果的已知风险因素.
- 它对肺移植 (LT) 接受者的影响尚未在全国范围内进行广泛研究.
研究的目的:
- 调查成年肺移植接受者手术前使用阿片类药物和术后结果之间的关联.
- 确定该患者群体中手术前阿片类药物使用的全国患病率和影响.
主要方法:
- 利用了美国成年肺移植接受者 (2011-2021) 移植受体科学注册表的数据.
- 包括来自药房数据集的处方数据,以识别手术前阿片类药物使用 (移植前≤6个月).
- 采用多变量回归来比较移植后的结果,包括呼吸系统支持,感染和死亡率.
主要成果:
- 在17285名肺移植患者中,17.9%的患者在手术前使用过阿片类药物.
- 手术前使用阿片类药物与移植后0-6个月服用阿片类药物的概率增加3.18倍,移植后6-12个月使用阿片类药物的概率增加14.29倍.
- 与16%更高的移植后死亡率和长时间使用呼吸机 (>48小时) 的风险增加有关.
结论:
- 术前阿片类药物使用是肺移植接受者移植后阿片类药物使用的最强独立风险因素.
- 它与增加的发病率和死亡率显著相关.
- 减少移植前和移植后阿片类药物使用的策略对于改善肺移植结果至关重要.
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