Brit J Surg:创伤后长期使用阿片类药物的危险因素与患者结局

2020-02-09 xing.T MedSci原创

由此可见,创伤与长期使用阿片类药物有关。这些患者在创伤后6-18个月内仍有较高的死亡风险。

阿片类药物滥用成为许多国家的严重危机,目前尚未确定创伤作为使用阿片类药物的指征。近日,外科疾病领域权威杂志British Journal of Surgery上发表了一篇研究文章,该研究旨在评估创伤性损伤是否可能与长期使用阿片类药物有关,并伴随长期死亡率的增加。

来自瑞典的受伤患者与对照者进行了年龄,性别和城市匹配。与瑞典卫生注册机构建立联系后,研究人员评估了创伤前后阿片类药物的使用量。在受伤的患者中,研究人员使用Logistic回归分析调查与长期阿片类药物使用相关的因素,并在创伤后第二季度通过至少一份处方进行评估阿片类药物使用情况。研究人员使用Cox回归研究过度死亡的风险。此外,研究人员还探讨了创伤后阿片类药物使用者的死亡原因。

该研究分析了13309名受伤患者和70621名对照者。暴露于创伤与长期阿片类药物的使用独立相关(比值比为3.28,95%CI为3.02至3.55);长期阿片类药物的使用与年龄、低学历、身体合并症、精神病合并症、创伤前阿片类药物使用和严重创伤有关。慢性阿片类药物使用者在创伤后6-18个月全因死亡的调整后风险比为1.82(95%CI为1.34至2.48)。在创伤前没有阿片类药物暴露的创伤患者中,结果相似。

由此可见,创伤与长期使用阿片类药物有关。这些患者在创伤后6-18个月内仍有较高的死亡风险。

原始出处:

E. von Oelreich.et al.Risk factors and outcomes of chronic opioid use following trauma.British Journal of Surgery.2020.https://doi.org/10.1002/bjs.11507

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2010170, encodeId=972e20101e03c, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Jul 04 05:48:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253104, encodeId=3edf1253104f4, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309150, encodeId=97e3130915056, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335293, encodeId=a7c3133529373, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480030, encodeId=096d148003086, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2010170, encodeId=972e20101e03c, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Jul 04 05:48:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253104, encodeId=3edf1253104f4, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309150, encodeId=97e3130915056, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335293, encodeId=a7c3133529373, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480030, encodeId=096d148003086, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2010170, encodeId=972e20101e03c, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Jul 04 05:48:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253104, encodeId=3edf1253104f4, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309150, encodeId=97e3130915056, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335293, encodeId=a7c3133529373, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480030, encodeId=096d148003086, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=)]
    2020-02-11 lhlxtx
  4. [GetPortalCommentsPageByObjectIdResponse(id=2010170, encodeId=972e20101e03c, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Jul 04 05:48:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253104, encodeId=3edf1253104f4, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309150, encodeId=97e3130915056, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335293, encodeId=a7c3133529373, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480030, encodeId=096d148003086, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2010170, encodeId=972e20101e03c, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Jul 04 05:48:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253104, encodeId=3edf1253104f4, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309150, encodeId=97e3130915056, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335293, encodeId=a7c3133529373, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480030, encodeId=096d148003086, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Feb 11 05:48:00 CST 2020, time=2020-02-11, status=1, ipAttribution=)]

相关资讯

NEJM:腔静脉滤器与创伤患者肺栓塞风险

研究认为,对于抗凝禁忌严重创伤患者,接受早期预防性放置腔静脉滤器治疗不能改善患者症状性肺栓塞或死亡风险

JAMA Surg:肌肉减少症和脑萎缩是评估老年人创伤预后的重要指标

老年创伤患者的咬肌肌肉减少症和脑萎缩与1年死亡率相关

Neurology:儿童非意外创伤所致脊髓硬膜下血肿

5月大男孩,非意外创伤致双侧颅内硬膜下血肿,神经系统查体配合欠佳,仅可见肢体退缩反射。脊柱成像(图)可见横跨T4-L5的硬脊膜下血肿伴脊髓受压。

J Endod:牙列创伤的评估和诊断

外伤性牙齿损伤包括许多下班后或在牙科诊所环境中的非计划单会经常看到的牙科急诊患者。尽管有多种创伤性的牙齿损伤,但是每种自身的推荐治疗方案、外伤牙列最初的评估和诊断对于这些病例的处理占有极其重要的环节。

癌症筛诊治应最小创伤、很大收益

我国恶性肿瘤(癌症)防治形势严峻,每年有超过280万人死于癌症,比全球癌症平均死亡率高17%,同时癌症患者的5年生存率不足发达国家的一半。这与我国癌症“早诊早治技术水平较低”“患者就诊时间普遍较晚”不无关系。

Chest:创伤和败血症患者的血浆线粒体DNA水平与急性呼吸窘迫综合征相关

由此可见,在两个严重疾病人群中血浆mtDNA水平与ARDS发生率相关。如果有支持的临床前数据,研究人员的发现可能表明循环线粒体DNA与肺损伤之间存在潜在的联系,值得作为ARDS的潜在靶向进行下一步研究。