在关节骨折手术后早期动员与长期阿片类药物治疗风险之间的关联
Yasmina Maria Tudorache1, Ina Trolle Andersen1, Thomas J Hjelholt2
1Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Olof Palmes Alle 43-45, 8200 Aarhus N, Aarhus, Denmark.
European geriatric medicine
|May 7, 2025
概括
在关节骨折手术后24小时内早期动员可显著降低长期阿片类药物治疗的风险. 这一发现凸显了早期患者流动性对于更好的康复结果的重要性.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 疼痛管理 疼痛管理
背景情况:
- 长期阿片类药物治疗 (LTOT) 是关节骨折手术后的常见并发症.
- 早期动员对部骨折后LTOT风险的影响仍然不完全理解.
研究的目的:
- 为了研究关节骨折手术后早期动员和在一年的随访中发展长期阿片类药物治疗的风险之间的联系.
主要方法:
- 丹麦基于人口的注册研究包括36229名65岁以上的患者,他们首次接受了关节骨折手术 (2016-2021年).
- 长期阿片类药物治疗被定义为手术后31至365天之间赎回的≥2处方.
- 治疗权重的稳定反向概率 (sIPT) 用于比较动员组 (≤24小时与24-36小时),同时考虑混因素和死亡率.
主要成果:
- 在24小时内动员的患者 (75%) 与在24-36小时之间动员的患者 (33.42%) 相比,LTOT的风险较低 (29.99%).
- 两组之间LTOT的加权风险差异为3.44% (95% CI:1.58-5.30).
- 虽然各组的年龄和骨折类型相似,但早期动员组的并发症较少,骨折前功能更好.
结论:
- 关节骨折手术后24小时内动员与长期阿片类药物治疗的风险降低有关.
- 早期动员是成功康复患者的关键组成部分,有可能减少并发症和死亡率.
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