在部骨折手术后的社会经济地位和慢性阿片类药物使用:丹麦基于人口的队列研究
Nickolaj Risbo1, Vera Ehrenstein1,2, Per Hviid Gundtoft3
1Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
European journal of pain (London, England)
|June 19, 2025
概括
在部骨折手术后,慢性阿片类药物的使用是常见的. 较低的社会经济地位,即单身生活,资产较少或教育程度较低,增加了长期使用阿片类药物和更高剂量的风险.
科学领域:
- 老年医学 老年医学
- 公共卫生 公共卫生
- 疼痛管理 疼痛管理
背景情况:
- 慢性阿片类药物使用是关节骨折手术后的重大并发症.
- 社会经济地位 (SEP) 是影响骨折后阿片类药物使用的潜在因素.
研究的目的:
- 研究骨折手术后社会经济地位 (SEP) 和慢性阿片类药物使用之间的关联.
- 分析SEP标志物对关节骨折患者阿片类药物剂量的影响.
主要方法:
- 2012-2021年丹麦全国注册数据包括52,801名65岁以上的患者接受关节骨折手术.
- 社会经济地位的评估是根据同居状态,流动资产和教育水平进行的.
- 慢性阿片类药物使用被定义为手术后31-365天内≥2次处方;剂量被转换为吗啡毫克相当量 (MME).
主要成果:
- 单独生活的患者的1年慢性阿片类药物使用风险 (33%) 比同居患者 (30%) 高.
- 流动资产低的患者 (37%) 和受教育程度低的患者 (33%) 与SES高的患者 (28%) 相比,慢性阿片类药物使用的风险更高.
- 在社会经济地位较低的患者中,在所有SEP标志物中,阿片类药物剂量 (MME/天) 始终更高.
结论:
- 大约三分之一的关节骨折患者在手术后的一年内持续使用阿片类药物.
- 较低的社会经济地位 (独自生活,资产较少,教育程度较低) 与慢性阿片类药物使用后关节骨折的风险和剂量增加有关.
- 临床医生应在处方阿片类药物时考虑患者的社会经济因素,并探索非药物疼痛管理策略.
相关概念视频
Opioid Analgesics: Morphine and Other Natural Cogeners
382
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
382
Opioid Analgesics: Synthetic and Semisynthetic Opioids
453
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
453
Analgesia and Pain Management
822
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
822


