长期使用阿片类药物在手术治疗骨折相关感染的骨科患者:数据链接研究
Andrew L Foster1, Jace Warren2, Melanie Proper3
1Jamieson Trauma Institute, Metro North Hospital and Health Service, Queensland Health, Cnr Butterfield St and Bowen Bridge Road, Herston, QLD, Australia; School of Clinical Medicine, Faculty of Health, Queensland University of Technology, Australia; Faculty of Medicine, University of Queensland, Australia.
Injury
|July 10, 2025
概括
骨折相关感染 (FRI) 在创伤手术后显著增加长期阿片类药物使用的可能性. 识别危险因素,如伤害前的阿片类药物使用和高伤害严重程度,对于更好的疼痛管理策略至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 疼痛管理 疼痛管理
背景情况:
- 骨折相关感染 (FRI) 是肌肉骨创伤的严重并发症.
- 在FRI患者中长期使用阿片类药物尚不清楚.
- 这项研究调查了FRI和没有FRI的创伤患者的慢性阿片类药物使用情况.
研究的目的:
- 为了比较创伤患者与没有FRI之间的慢性阿片类药物使用率.
- 在FRI患者中确定与慢性阿片类药物使用相关的风险因素.
主要方法:
- 分析了澳大利亚昆士兰州 (2014-2015) 的19218名经营管理创伤患者的队列.
- 数据包括住院记录,社区阿片类药物分发和死亡率.
- 慢性阿片类药物治疗 (COT) 被定义为90天以上的累积处方,并使用多变量逻辑回归分析.
主要成果:
- 2.1%的患者发生FRI (394/19,218).
- FRI患者更有可能接受阿片类药物 (68%vs48.5%) 和发展COT (29.0%vs23.8%).
- 伤害前的阿片类药物使用,高伤害严重程度,长时间住院 (>21天) 和多次修复手术 (>2) 是FRI患者COT的风险因素.
结论:
- 与骨折相关的感染是长期使用阿片类药物的重要危险因素.
- 识别有COT风险的患者可以为阿片类药物管理和康复策略提供信息.
- 改善FRI的预防和治疗对于减轻长期阿片类药物依赖至关重要.
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