药物治疗阿片类药物使用障碍和良性子宫切除术的术后结果
Yongmei Huang1, Alicia H Li1, June Y Hou1
1Department of Obstetrics and Gynecology, Department of Anesthesiology, and Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York; Center for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey; and New York State Psychiatric Institute, New York, New York.
药物治疗阿片类药物使用障碍 (MOUD) 的使用,包括甲和布普伦诺芬,与手术并发症的减少以及经过子宫切除术的患者的医疗保健使用减少有关. 较长的MOUD治疗 (超过90天) 显示出更好的结果.
科学领域:
- 产科和妇科 产科和妇科
- 成 药物 药物 药物 药物
- 医疗保健服务研究 医疗服务研究
背景情况:
- 阿片类药物使用障碍 (OUD) 是一个重要的公共卫生问题.
- 患有OUD的手术患者可能面临并发症和医疗保健利用的风险增加.
- 药物治疗阿片类药物使用障碍 (MOUD) 对这一群体手术结果的影响尚未完全理解.
研究的目的:
- 评估MOUD使用与手术并发症之间的关联.
- 评估MOUD使用和医疗保健利用之间的关系,在经过子宫切除术的OUD患者中.
- 为了比较当前MOUD用户和非用户之间的结果.
主要方法:
- 对MarketScan研究数据库 (2016-2021) 的回顾性分析.
- 鉴定了患有OUD的患者,因为良性征兆而接受了子宫切除术.
- 评估了手术前的MOUD使用 (甲或布普伦诺芬),并使用倾向性评分权重来分析结果,包括术后并发症,阿片类药物处方,再入院和ED访问.
主要成果:
- 当前使用MOUD与手术前并发症 (27.7%vs33.9%) 和30天 (19.1%vs27.7%) 和90天 (32.6%vs42.8%) 内的ED访问减少有关.
- 甲和布普伦诺芬都显示出类似的积极结果.
- 与90天或更短的MOUD患者相比,在90天以上的MOUD患者的并发症风险和医疗利用率较低.
结论:
- 使用MOUD与改善手术结果和减少OUD患者接受子宫切除术的医疗利用率有关.
- 研究结果支持使用甲和布普伦诺芬来改善外科手术的结果.
- 持续的MOUD治疗 (超过90天) 似乎特别有利于改善子宫切除术的结果.
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