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冠状动脉搭桥手术后阿片类药物依赖与术后并发症的关联:一项倾向匹配研究。

The association of opium dependence and postoperative complications following coronary artery bypass graft surgery: a propensity-matched study.

作者信息

Sadeghian Saeed, Karimi Abbasali, Dowlatshahi Samaneh, Ahmadi Seyed Hossein, Davoodi Saeed, Marzban Mehrab, Movahedi Namvar, Abbasi Kyomars, Tazik Mokhtar, Fathollahi Mahmood Sheikh

机构信息

Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Opioid Manag. 2009 Nov-Dec;5(6):365-72. doi: 10.5055/jom.2009.0036.

Abstract

OBJECTIVE

Opium is an overwhelming public health problem in some countries. Different studies have suggested this drug as a risk factor for cardiovascular disease. Although the effect of opium on immune system, lung disease, nephropathy, stroke, and cardiac arrhythmia has been found in different studies, its effect on postoperation complications is not clear yet. The authors conducted this study to assess the effect of opium on post operation in hospital complications among patients who underwent coronary artery bypass graft.

DESIGN

The authors retrospectively analyzed the data in this study.

SETTING

This study has been done at Tehran Heart Center.

PATIENTS

A total of 4,398 patients who had undergone isolated CABG were studied.

MAIN OUTCOME MEASURE

Patients who fulfilled the DSM-IV-TR criteria for opium dependence (by smoking) were enrolled as Opium Dependent Patients. Also outcome variables were: Perioperative MI, septicemia, UTI, TIA, continuous coma, prolonged ventilation, pulmonary embolism, renal failure, acute limb ischemia, heart block, AF, mortality.

RESULTS

The prevalence of opium dependence was 15.6percent among patients. The authors used a propensity matched model to analyze the relationship between opium and post operation complications. The authors adjusted opium and non-opium dependent patients in all of the baseline preoperative risk factors, so all of the matched patients were same and there was no bias in assessment.

CONCLUSION

Opium dependent patients had significantly longer resource utilization. However, no significant relationship was found between opium dependence and other cardiac and non cardiac in hospital complications.

摘要

目的

在一些国家,鸦片是一个严重的公共卫生问题。不同研究表明这种药物是心血管疾病的一个风险因素。尽管在不同研究中已发现鸦片对免疫系统、肺部疾病、肾病、中风和心律失常有影响,但其对术后并发症的影响尚不清楚。作者开展这项研究以评估鸦片对接受冠状动脉搭桥术患者术后医院并发症的影响。

设计

作者对本研究中的数据进行回顾性分析。

地点

本研究在德黑兰心脏中心进行。

患者

共研究了4398例接受单纯冠状动脉搭桥术的患者。

主要观察指标

符合DSM-IV-TR鸦片依赖标准(通过吸烟)的患者被纳入鸦片依赖患者组。此外,观察变量包括:围手术期心肌梗死、败血症、尿路感染、短暂性脑缺血发作、持续昏迷、通气延长、肺栓塞、肾衰竭、急性肢体缺血、心脏传导阻滞、房颤、死亡率。

结果

患者中鸦片依赖的患病率为15.6%。作者使用倾向匹配模型分析鸦片与术后并发症之间的关系。作者在所有术前基线风险因素中对鸦片依赖和非鸦片依赖患者进行了调整,因此所有匹配患者情况相同,评估中不存在偏差。

结论

鸦片依赖患者的资源利用时间显著更长。然而,未发现鸦片依赖与其他心脏及非心脏医院并发症之间存在显著关系。

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