创伤性骨科损伤并非出院后阿片类药物高消耗量的独立危险因素。
Traumatic Orthopaedic Injury Is Not an Independent Risk Factor for High Postdischarge Opioid Consumption.
作者信息
Flanagan Christopher D, Fuell Wysong Elena, Ramey J Scott, Gunasekar Ashwath, Vallier Heather A
机构信息
Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2017 Nov 15;1(8):e058. doi: 10.5435/JAAOSGlobal-D-17-00058. eCollection 2017 Nov.
INTRODUCTION
The purpose of this study was to quantify how opioid use in patients with traumatic injury compared with opioid use in patients undergoing elective arthroplasty.
METHODS
In a retrospective review, 235 adult trauma patients treated surgically for fracture were compared with 98 patients undergoing elective total hip or knee arthroplasty. Inpatient, discharge, and postdischarge opioid use were recorded in oral morphine equivalents (OMEs).
RESULTS
There were no differences between trauma and elective arthroplasty patients for inpatient opioid use (OME/day: 70.2 vs. 67.3; = 0.53), discharge prescription (OME: 542 vs. 594; = 0.13), or postdischarge opioid use (OME: 986 vs. 1,147; = 0.29). Postdischarge opioid use was positively correlated with Caucasian race, intensive care unit admission, baseline alcohol or opioid use, and higher discharge prescriptions ( < 0.0001; adjusted R = 0.127). Discharge prescription amount was the most significant predictor.
DISCUSSION
Traumatic injury is not a predictor of high post-discharge opioid use. Demographic, social, and physician prescribing behaviors contribute to higher postdischarge opioid consumption.
引言
本研究的目的是量化创伤性损伤患者的阿片类药物使用情况，并与接受择期关节置换术的患者的阿片类药物使用情况进行比较。
方法
在一项回顾性研究中，将235例接受手术治疗骨折的成年创伤患者与98例接受择期全髋关节或膝关节置换术的患者进行比较。以口服吗啡当量（OME）记录住院期间、出院时及出院后的阿片类药物使用情况。
结果
创伤患者与择期关节置换术患者在住院期间阿片类药物使用量（OME/天：70.2对67.3；P = 0.53）、出院处方量（OME：542对594；P = 0.13）或出院后阿片类药物使用量（OME：986对1147；P = 0.29）方面均无差异。出院后阿片类药物使用量与白种人、入住重症监护病房、基线酒精或阿片类药物使用情况以及较高的出院处方量呈正相关（P < 0.0001；调整后R = 0.127）。出院处方量是最显著的预测因素。
讨论
创伤性损伤并非出院后高阿片类药物使用量的预测因素。人口统计学、社会因素及医生的处方行为导致出院后阿片类药物消费量增加。
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