在接受治疗前的阿片类药物的使用和相关结果,在患者中进行了为下周围动脉疾病重血管化
Jeppe Kofoed Petersen1, Lucas Grove Vejlstrup Bager1, Lauge Østergaard1
1Department of Cardiology, University Hospital Copenhagen-Rigshospitalet, Denmark.
概括
患有外周动脉疾病 (PAD) 并且正在进行重血管化的患者中使用阿片类药物是常见的,并且与较高的死亡率有关. 谨慎的处方和随访对于管理疼痛和降低高风险组的风险至关重要.
科学领域:
- 血管外科 血管外科
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 周围动脉疾病 (PAD) 影响着众多患者,通常需要重血管.
- 在慢性疼痛管理中,阿片类药物的使用是令人担忧的,对PAD患者有潜在的影响.
- 了解重血管化后阿片类药物使用模式及其对死亡率的影响至关重要.
研究的目的:
- 评估下肢PAD患者在重血管化后继续使用阿片类药物的比例.
- 检查重血管化前阿片类药物治疗与出院后全因死亡率之间的关联.
主要方法:
- 通过使用丹麦国家注册表 (1996-2018) 进行全国性的回顾性注册表研究.
- 鉴定了首次接受PAD内血管或外科重血管化的患者.
- 根据入院前的阿片类药物使用情况 (新的,长期的,最近的,以前的,非使用者) 分类患者,并使用多变量考克斯回归分析结果.
主要成果:
- 包括4万多名患者;5.4%是新的阿片类药物使用者,22.9%是长期使用者,14.5%是最近使用者,19.0%是前使用者,38.2%是非使用者.
- 阿片类药物使用者,特别是长期使用者,在出院后处方补充率更高.
- 与非使用者相比,1年全因死亡风险比为新使用者1.64,长期使用者1.59,最近使用者1.13.
结论:
- 一个显著的PAD患者小组表现出大量的阿片类药物使用,并面临高死亡风险后revascularisation.
- 出院后继续接受阿片类药物治疗是常见的,这强调了需要谨慎的处方和结构化的随访.
- 在重血管化前使用阿片类药物与较高的全因死亡率有关,这可能表明疾病严重程度更高.
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