急性胰腺炎的止痛表型:对两项前性全球队列研究的集群分析
Chris Varghese1, Cecilie Siggaard Knoph2, Nejo Joseph3
1Department of Surgery, University of Auckland, Auckland, New Zealand; Mayo Clinic, Rochester, MN, United States.
概括
急性胰腺炎 (AP) 疼痛管理显示出与疾病严重程度相关的不同患者群. 止痛药处方的全球变化显著影响患者的治疗结果.
科学领域:
- 胃肠病学 胃肠病学
- 疼痛管理 疼痛管理
- 临床研究 临床研究
背景情况:
- 有效的疼痛管理对于急性胰腺炎 (AP) 治疗和预后至关重要.
- 根据疼痛管理策略识别患者表型,可以提供预后见解.
研究的目的:
- 根据急性胰腺炎的疼痛管理策略,确定不同的患者群.
- 评估这些确定的患者集群的预后影响.
主要方法:
- 在两个国际前性队列研究中,对3469名AP患者的数据进行了潜在类分析.
- 分析了人口统计数据和在呈现后72小时内使用止痛药的情况.
- 使用多变量混合效应物流回归来检查集群分配和AP结果.
主要成果:
- 确定了五个独特的患者群体:早期使用NSAIDs,最小的止痛药使用,强烈的阿片类药物使用,早期多式联络止痛药使用和早期弱阿片类药物使用.
- 早期的NSAID使用集群与非严重的AP相关,这表明NSAID使用可能与轻度疼痛相关.
- 在141个国际中心观察到止痛药处方模式的显著差异.
结论:
- 在AP疼痛管理中的不同患者群体与AP严重程度相关.
- 止痛药处方存在全球显著差异,影响患者的治疗结果.
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