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疼痛控制不足与创伤患者急诊室利用之间的关联

Sophia M Smith¹, Rachel Adams², Emily J Ha³

¹Boston Medical Center, Department of Surgery, Boston, Massachusetts; Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.

The Journal of surgical research

|May 29, 2025

概括

在没有阿片类药物的情况下出院的创伤患者因疼痛而访问急诊室 (ED) 的次数更高. 在出院时开处方阿片类药物可能会减少复诊,但开处方的数量对疼痛控制无意义.

科学领域:

创伤学创伤学创伤学
疼痛管理疼痛管理
医疗保健服务研究医疗服务研究

背景情况:

高达20%的创伤患者在30天内再次访问急诊室 (ED),通常是因为疼痛.
住院患者使用阿片类药物,出院处方和随后因疼痛而访问ED之间的关系尚不清楚.

研究的目的:

为了调查阿片类药物释放处方和急诊室 (ED) 对创伤患者疼痛的访问之间的联系.
为了确定是否处方阿片类药物的数量在释放时影响ED重新访问不受控制的疼痛.

主要方法:

对成人创伤患者进行回顾性病例对照研究,这些患者在出院时需要使用阿片类药物.
在城市一级I创伤中心对2018-2021年的数据进行分析.
多变量后勤回归来评估出院阿片类药物处方和处方疼痛控制持续时间对ED疼痛访问的影响.

主要成果:

74.76%的患者接受了阿片类药物处方;10.64%的患者因疼痛而进行ED访问.
服用阿片类药物出院的患者因疼痛而出院的几率明显降低 (OR 0.66,P=0.04).
处方疼痛控制的处方日没有显著与减少ED访问不受控制的疼痛相关 (OR 0.96,P=0.19).

结论:

缺乏阿片类药物释放处方与需要阿片类药物的创伤患者中疼痛ED访问增加有关.
对于处方阿片类药物的患者,这种数量没有显著影响ED复诊,这表明保守的处方方法可能是合适的.
优化疼痛管理和潜在地减少ED复诊需要谨慎的住院疼痛控制,适当的逐渐减缓,以及相应的出院处方.

关键词:

应急部门的紧急情况部门.在阿片类药物中,阿片类药物疼痛管理疼痛管理创伤是一种创伤.

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