骨科多创伤患者慢性阿片类药物使用的患病率和风险
Michael E Held1, Alex G Otwell2, Steven M Cherney1
1Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 W. Markham Drive, Little Rock, AR, 72205, USA.
Archives of orthopaedic and trauma surgery
|April 17, 2025
概括
慢性阿片类药物使用在骨科多创伤患者中很普遍. 入院前的阿片类药物使用和较高的伤害严重程度得分是多重骨折后长期阿片类药物依赖的关键风险因素.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 疼痛管理 疼痛管理
背景情况:
- 长时间使用阿片类药物会导致不良后果.
- 在多创伤中影响慢性阿片类药物使用的患者特定因素尚未得到研究.
研究的目的:
- 为了确定骨科多创伤患者慢性阿片类药物使用的患病率.
- 为了确定与慢性阿片类药物消费相关的患者特异性风险因素.
主要方法:
- 对167名多创伤患者的回顾性队列研究,这些患者有多次下肢骨折.
- 从国家监测数据库分析的阿片类药物处方数据 (手术前3个月至手术后1年).
- 预测第二级回顾性队列.
主要成果:
- 41%的患者在创伤后表现出慢性阿片类药物使用.
- 在入院前使用阿片类药物 (OR 9.02) 和伤害严重性得分 (ISS) >15 (OR 3.62) 显著增加了慢性使用的几率.
- 更高的手术数量,开放骨折和更高的吗啡毫克相当量 (MME) 与慢性阿片类药物使用相关.
结论:
- 慢性阿片类药物使用是多创伤的一个重要问题.
- 在入院前使用阿片类药物,高ISS和增加医院内阿片类药物需求的患者需要密切监测.
- 减轻阿片类药物消费和促进非阿片类药物替代品对于应对长期挑战至关重要.
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