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阿片类药物中毒住院情况:1998 - 2004年丹麦一项基于全国人口的研究

Hospitalizations for opioid poisoning: a nation-wide population-based study in Denmark, 1998-2004.

作者信息

Bjørn Anne-Mette Bay, Jepsen Peter, Larsson Heidi Jeanet, Thomsen Henrik Frederik, Kieler Helle, Ehrenstein Vera, Christensen Steffen

机构信息

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.

出版信息

Addiction. 2009 Jan;104(1):104-8. doi: 10.1111/j.1360-0443.2008.02420.x.

Abstract

AIMS

To assess hospitalization rates (HR) for poisoning with heroin, methadone or strong analgesics and relate them to quantities of prescribed methadone and strong analgesics in Denmark between 1998 and 2004.

DESIGN

Population-based ecological study.

SETTINGS

We extracted data on all emergency department visits and hospital admissions registered in the Danish National Patient Registry with a diagnosis of poisoning with heroin (n = 1688), methadone (n = 173) or strong analgesics (n = 384). To ascertain sale of prescribed medications we used data from the Danish Medicines Agency.

MEASUREMENTS

Age- and gender-standardized HR and defined daily doses (DDD) per 1000 people per day.

FINDINGS

HR for heroin poisoning was 4.4 [95% confidence interval (CI): 3.8-4.9] per 100,000 person-years (p-y) in 1998 and 4.6 (CI: 4.0-5.2) per 100,000 p-y in 2004. HR for methadone poisoning increased from 0.1 (CI: 0.0-0.2) per 100,000 p-y in 1998 to 1.1 (CI: 0.8-1.4) per 100,000 p-y in 2004. HR for poisoning with strong analgesics increased from 0.6 (CI: 0.4-0.9) per 100,000 p-y in 1998 to 2.1 (CI: 1.8-2.6) per 100,000 p-y in 2004. The sale of prescribed strong analgesics (5.0 DDD per 1000 people per day in 1998 to 5.9 DDD in 2004) and methadone (3.0 DDD per 1000 people per day in 1998 to 3.4 DDD in 2004) increased slightly between 1998 and 2004.

CONCLUSION

Increasing sale of prescribed methadone and strong analgesics coincided with increasing HRs of poisoning with these drugs, whereas HR of heroin poisoning varied. Further longitudinal studies are important for the guidance of future policy making.

摘要

目的

评估1998年至2004年间丹麦海洛因、美沙酮或强效镇痛药中毒的住院率(HR),并将其与美沙酮和强效镇痛药的处方量相关联。

设计

基于人群的生态学研究。

背景

我们从丹麦国家患者登记处提取了所有诊断为海洛因中毒(n = 1688)、美沙酮中毒(n = 173)或强效镇痛药中毒(n = 384)的急诊科就诊和住院数据。为确定处方药的销售情况,我们使用了丹麦药品管理局的数据。

测量指标

年龄和性别标准化的住院率以及每1000人每天的限定日剂量(DDD)。

研究结果

1998年海洛因中毒的住院率为每10万人年4.4 [95%置信区间(CI):3.8 - 4.9],2004年为每10万人年4.6(CI:4.0 - 5.2)。美沙酮中毒的住院率从1998年的每10万人年0.1(CI:0.0 - 0.2)增至2004年的每10万人年1.1(CI:0.8 - 1.4)。强效镇痛药中毒的住院率从1998年的每10万人年0.6(CI:0.4 - 0.9)增至2004年的每10万人年2.1(CI:1.8 - 2.6)。1998年至2004年间,处方药强效镇痛药(从每1000人每天5.0 DDD增至5.9 DDD)和美沙酮(从每1000人每天3.0 DDD增至3.4 DDD)的销售量略有增加。

结论

美沙酮和强效镇痛药处方量的增加与这些药物中毒住院率的上升同时出现,而海洛因中毒的住院率有所不同。进一步的纵向研究对未来政策制定的指导很重要。

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