创伤患者长期使用阿片类药物:一个多中心队列研究
Wardah Rafaqat1, Matthew K Simpson, Ikemsinachi C Nzenwa
1From the Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery (W.R., M.K.S., I.C.N., Y.A., V.S.P., J.O.H.), Massachusetts General Hospital, Harvard Medical School; Center for Surgery and Public Health (S.I., G.A.A., J.H.E.), Brigham and Women's Hospital; Division of Trauma, Department of Surgery (S.E.S.), Boston Medical Center, Boston, Massachusetts; and the Department of Health Law, Policy & Management (J.H.E.), Boston University School of Public Health.
大约16%的创伤患者经历了长期处方阿片类药物使用 (LTPOU). 预测因素包括心理健康障碍和低教育程度,而LTPOU与更糟糕的功能结果有关.
科学领域:
- 创伤外科手术是什么
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 创伤患者面临长期处方阿片类药物使用 (LTPOU) 的高风险,原因是普遍存在的创伤后疼痛.
- 在创伤人群中,LTPOU的风险因素尚不清楚.
- 了解LTPOU预测因素和结果对于这个脆弱群体至关重要.
研究的目的:
- 确定创伤患者中LTPOU的预测因子.
- 检查与创伤幸存者的LTPOU相关的长期功能结果.
主要方法:
- 809名创伤患者的回顾性队列研究 (伤害严重性评分≥9).
- 患者在受伤后6-12个月接受了关于LTPOU (定义为在调查后3个月内使用阿片类药物) 的调查.
- 循序渐进的后勤回归用于识别LTPOU预测因子,调整共变量.
主要成果:
- 15.7%的患者报告了LTPOU.
- 预测LTPOU的预测因素包括并发症,与工作有关的伤害,医疗补助保险,低教育,先前的心理健康障碍和多创伤.
- 不管慢性疼痛状态如何,LTPOU与PTSD,经济困难和功能限制有关.
结论:
- 近16%的创伤患者报告LTPOU.
- 确定的主要预测因素是先前的心理健康问题,低教育程度,医疗补助保险,并发症和多创伤/工作相关伤害.
- LTPOU与不良的功能结果有关,突出了针对性干预的需要.
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