Grau-López Lara, Roncero Carlos, Daigre Constanza, Gonzalvo Begoña, Bachiller Diana, Rodriguez-Cintas Laia, Egido Ángel, Casas Miquel
CAS Vall Hebrón, Hospital Universitario Vall Hebron, Agencia de Salud Pública de Barcelona, España.
Adicciones. 2012;24(2):115-22.
This work describes the profile of patients with relapse after hospital detoxification at six months of outpatient follow-up. An observational and prospective study was carried out in patients with substance-dependence disorder who were in the Detoxification Unit of the Vall d'Hebron University Hospital (Barcelona) between June 2009 and October 2010. Demographic, clinical, diagnostic and therapeutic variables were assessed. The criterion for relapse was a return to use of the substance that had led to hospitalization, and relapse was assessed by means of anamnesis, breathalyzer and/or urine analysis. Study variables were compared between patients who relapsed and those who did not. Of the 165 patients included, 108 patients finished the study (75% males, age 37.7 ± 9.5 years). A total of 72.2% had relapsed at the 6-month follow-up. Profile of patients who relapsed was: hospitalized for heroin detoxification (91.7% vs 8.3%, p = .038), polyconsumers (71.4% vs 32%, p = .05), high substance use in the hours prior to admission as a "farewell" (61.5% vs 39.5%, p = .04), patients with comorbidity (44.9% vs 23.3%, p = .04) and patients with affective disorders (19.5% vs 3.2%, p = .005). Detoxification from opiates and use in the hours prior to admission were associated independently with relapse at 6 months. There is a high percentage of relapses after hospital detoxification. Patients most likely to relapse are those dependent on opiates and those with compulsive use immediately prior to hospitalization.
这项研究描述了在门诊随访6个月时医院戒毒后复发患者的情况。对2009年6月至2010年10月期间在巴塞罗那瓦尔德希伯伦大学医院戒毒科的物质依赖障碍患者进行了一项观察性前瞻性研究。评估了人口统计学、临床、诊断和治疗变量。复发的标准是重新使用导致住院的物质,通过问诊、呼气酒精含量测定仪和/或尿液分析评估复发情况。比较了复发患者和未复发患者的研究变量。纳入的165例患者中,108例完成了研究(75%为男性,年龄37.7±9.5岁)。在6个月的随访中,共有72.2%的患者复发。复发患者的情况如下:因海洛因戒毒住院(91.7%对8.3%,p = 0.038)、多药使用者(71.4%对32%,p = 0.05)、入院前数小时大量使用物质作为“告别”(61.5%对39.5%,p = 0.04)、有合并症的患者(44.9%对23.3%,p = 0.04)和有情感障碍的患者(19.5%对3.2%,p = 0.005)。阿片类药物戒毒和入院前数小时的使用与6个月时的复发独立相关。医院戒毒后复发率很高。最有可能复发的患者是那些依赖阿片类药物的患者以及住院前有强迫性使用行为的患者。