Lee Cynthia Wei-Sheng, Muo Chih-Hsin, Liang Ji-An, Sung Fung-Chang, Kao Chia-Hung
Center for Drug Abuse and Addiction, China Medical University Hospital and China Medical University , Taichung , Taiwan .
Brain Inj. 2014;28(10):1353-7. doi: 10.3109/02699052.2014.910836. Epub 2014 Jun 2.
BACKGROUND: This study investigated the relationship between recent morphine use and risk of subdural haemorrhage (SDH) in patients with cancer. METHODS: This study identified a malignancy cohort of 25,322 patients who had never received morphine treatment. In this malignancy cohort, 200 patients who subsequently developed SDH were designated as the SDH group. Control-group patients without SDH were selected from the malignancy cohort and were matched ∼4:1 to each SDH case for age, sex, year of cancer diagnosis and index year. Morphine use was designated as 'recent' if the prescription duration covered the index date or ended within 6 months before the index date. Logistic regression was used to estimate odds ratios and 95% confidence intervals and a multivariable model was applied to control for age, sex and cerebrovascular disease. RESULTS: Compared with non-morphine users, patients with cancer who received morphine within 6 months of the index date exhibited a 2.58-fold (95% CI = 1.23-5.39) increase in the risk of developing SDH. The risk of SDH development increased as the duration of morphine treatment increased. CONCLUSION: The incidence of SDH in patients with cancer in Taiwan is associated with recent morphine treatment (≤6 months) and is dependent on the duration of morphine use.
背景:本研究调查了癌症患者近期使用吗啡与硬膜下出血(SDH)风险之间的关系。 方法:本研究确定了一个由25322名从未接受过吗啡治疗的患者组成的恶性肿瘤队列。在这个恶性肿瘤队列中,200名随后发生SDH的患者被指定为SDH组。从恶性肿瘤队列中选择无SDH的对照组患者,并按年龄、性别、癌症诊断年份和索引年份与每个SDH病例以约4:1的比例进行匹配。如果处方持续时间涵盖索引日期或在索引日期前6个月内结束,则将吗啡使用指定为“近期”。采用逻辑回归估计比值比和95%置信区间,并应用多变量模型控制年龄、性别和脑血管疾病。 结果:与未使用吗啡的患者相比,在索引日期前6个月内接受吗啡治疗的癌症患者发生SDH的风险增加了2.58倍(95%CI = 1.23 - 5.39)。随着吗啡治疗持续时间的增加,发生SDH的风险也增加。 结论:台湾癌症患者SDH的发生率与近期(≤6个月)吗啡治疗有关,且取决于吗啡使用的持续时间。
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