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美国儿童和青少年的处方阿片类药物暴露情况:2000-2015 年。

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000-2015.

机构信息

Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, Ohio.

Central Ohio Poison Center, Columbus, Ohio; and.

出版信息

Pediatrics. 2017 Apr;139(4). doi: 10.1542/peds.2016-3382. Epub 2017 Mar 20.

Abstract

OBJECTIVES

This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States.

METHODS

Data from the National Poison Data System for 2000 through 2015 were analyzed.

RESULTS

Poison control centers received reports of 188 468 prescription opioid exposures among children aged <20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78-2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06-7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92-3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21-5.00). The rate of prescription opioid-related suspected suicides among teenagers increased by 52.7% during the study period.

CONCLUSIONS

Prescription opioid-related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.

摘要

目的

本研究分析并比较了美国 20 岁以下儿童和青少年使用处方类阿片的情况。

方法

对 2000 年至 2015 年国家毒物数据系统的数据进行了分析。

结果

2000 年至 2015 年,毒理控制中心共收到 188468 例 20 岁以下儿童使用处方类阿片的报告。在研究早期,暴露的年度数量和比率增加,但在 2009 年后下降,除丁丙诺啡的暴露情况在研究的最后 3 年有所增加。氢可酮的暴露占比最大(28.7%),47.1%接受丁丙诺啡治疗的儿童被送医治疗(HCF)。与 0-5 岁儿童(比值比[OR]:2.86;95%置信区间[CI]:2.78-2.94)或 6-12 岁儿童(OR:6.62;95% CI:6.06-7.02)相比,青少年被送医的几率更高。与 0-5 岁儿童(OR:3.03;95% CI:2.92-3.15)或 6-12 岁儿童(OR:4.59;95% CI:4.21-5.00)相比,青少年发生严重医疗后果的几率也更高。在此期间,青少年与处方类阿片相关的疑似自杀率增加了 52.7%。

结论

青少年接受处方类阿片治疗的 HCF 入院率和严重医疗后果更高。与其他处方类阿片的趋势相反,丁丙诺啡的使用量近年来有所增加;0-5 岁儿童占丁丙诺啡暴露的近 90%。这些发现表明,需要采取更多的预防措施。

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