医疗状况、药物使用及其与后续机动车事故伤害的关系：对加拿大国家人口健康调查的考察。

Medical conditions, medication use, and their relationship with subsequent motor vehicle injuries: examination of the Canadian National Population Health Survey.

机构信息

Population and Community Health Unit, Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.

出版信息

Traffic Inj Prev. 2012;13(3):327-36. doi: 10.1080/15389588.2012.654411.

DOI:10.1080/15389588.2012.654411

PMID:22607256

Abstract

PURPOSE

To examine the effects of various medical conditions and medications on subsequent motor vehicle injuries (MVIs).

METHOD

The National Population Health Survey, a large, nationally representative, longitudinal study of Canadians, included self-reported medical conditions of asthma, arthritis/rheumatism, back problems excluding arthritis, high blood pressure, migraine headaches, diabetes, heart disease and distress, and medication use during the past month for asthma, high blood pressure, diabetes, heart, codeine/pethidine (Demerol)/morphine, other pain relievers, antidepressants, tranquilizers, and sleeping medication. Path analyses were used to examine the odds of subsequent MVI for different medical conditions and medication use reported prior to the MVI (in the previous wave of the survey) while controlling for age and sex.

RESULTS

Increased odds of subsequent MVIs were found for asthma (odds ratio [OR]: 1.864, 95% confidence interval [CI]: 1.281, 2.713), arthritis/rheumatism (OR: 1.659, 95% CI: 1.163, 2.365), back problems (OR: 2.169, 95% CI: 1.624, 2.895), and migraines (OR: 1.631, 95% CI: 1.125, 2.364) but not for high blood pressure (OR: 1.435, 95% CI: 0.944, 2.181), diabetes (OR: 1.479, 95% CI: 0.743, 2.944), heart disease (OR: 2.627, 95% CI: 0.941, 7.334) or distress (OR: 1.153, 95% CI: 0.840, 1.581). Except for migraine with codeine/pethidine/morphine, this effect persisted regardless of whether medication was used to treat the condition. Respondents who reported using certain medications, namely, codeine/pethidine/morphine (OR: 2.215, 95% CI: 1.274, 3.850), other pain medication (OR: 1.630, 95% CI: 1.242, 2.139), antidepressants (OR: 2.664. 95% CI: 1.602, 4.429), and sleeping medication (OR: 2.059, 95% CI: 1.161, 3.651), had increased odds of subsequent MVI, independent of related medical condition, whereas tranquillizers showed no increased odds of subsequent MVIs.

CONCLUSIONS

This study suggests that the relationship between medical conditions, medications, and MVIs is complex but consistent with other studies.

摘要

目的

研究各种医疗状况和药物对随后发生的机动车事故（MVI）的影响。

方法

全国人口健康调查是一项对加拿大人大规模、全国代表性的纵向研究，包括自我报告的哮喘、关节炎/风湿病、非关节炎背部问题、高血压、偏头痛、糖尿病、心脏病和精神困扰等医疗状况，以及过去一个月内使用治疗哮喘、高血压、糖尿病、心脏病、可待因/哌替啶（度冷丁）/吗啡、其他止痛药、抗抑郁药、镇静剂和睡眠药物的情况。路径分析用于检查在 MVI 之前（在前一波调查中）报告的不同医疗状况和药物使用与年龄和性别控制因素相关的随后发生 MVI 的可能性。

结果

发现随后发生 MVI 的可能性增加了哮喘（比值比 [OR]：1.864，95%置信区间 [CI]：1.281，2.713）、关节炎/风湿病（OR：1.659，95% CI：1.163，2.365）、背部问题（OR：2.169，95% CI：1.624，2.895）和偏头痛（OR：1.631，95% CI：1.125，2.364），但高血压（OR：1.435，95% CI：0.944，2.181）、糖尿病（OR：1.479，95% CI：0.743，2.944）、心脏病（OR：2.627，95% CI：0.941，7.334）或精神困扰（OR：1.153，95% CI：0.840，1.581）则不然。除非偏头痛使用可待因/哌替啶/吗啡治疗，否则这种影响持续存在，无论是否使用药物来治疗该病症。报告使用某些药物的受访者，即可待因/哌替啶/吗啡（OR：2.215，95% CI：1.274，3.850）、其他止痛药（OR：1.630，95% CI：1.242，2.139）、抗抑郁药（OR：2.664，95% CI：1.602，4.429）和睡眠药物（OR：2.059，95% CI：1.161，3.651），随后发生 MVI 的可能性增加，而与相关医疗状况无关，而镇静剂则没有增加随后发生 MVI 的可能性。