修订后阿片类药物使用轨迹 整体关节整形术:基于人口的队列研究
Martin G Stisen1, Alma B Pedersen2, Katie J Sheehan3
1Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark.
The Journal of arthroplasty
|May 28, 2025
概括
修订关节整形术患者显示持续使用阿片类药物,其中26%仍在手术后2年使用. 确定患者的风险因素对于修复部手术后个性化疼痛管理至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 修订关节整形术 (THA) 患者与初级THA相比,面临持续术后阿片类药物使用的风险更高.
- 长期使用阿片类药物的相关不良影响引发了严重的安全问题.
- 在修订THA后,对阿片类药物使用和风险患者个人资料的时间变化有有限的了解.
研究的目的:
- 在修订THA后的头两年内确定明显的阿片类药物使用轨迹.
- 描述与不同阿片类药物使用模式相关的患者人口统计和临床因素.
主要方法:
- 一项基于人口的队列研究,对12314名接受首次修订THA (1995-2019) 的患者,使用丹麦关节整形注册表数据.
- 基于组的轨迹模型分析了来自丹麦国家处方注册表的季度平均每日吗啡毫克相当量 (MME).
- 后勤回归评估了临床特征和轨迹组成员之间的关联.
主要成果:
- 阿片类药物的使用量从Q1的74%下降到Q5-Q8的THA后修订后Q26%.
- 三种不同的轨迹出现了:最小使用 (76%),稳定使用 (18%) 和高使用 (6%).
- 稳定和高使用组的患者与最低使用组相比,表现出较差的健康和社会地位.
结论:
- 在THA修订两年后,很大一部分患者 (26%) 仍然是阿片类药物使用者,这可能会导致不良事件的风险.
- 调查结果强调了为减轻持续的阿片类药物使用量身定制的术后疼痛管理策略的必要性.
- 个性化方法对于解决长期阿片类药物依赖的复杂问题至关重要 后修复部手术.
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