Dayyani Mojtaba, Zabihyan Samira, Salehi Maryam, Baharvahdat Humain, Ahmadi Sina, Etemadrezaie Hamid
Department of Neurosurgery, Ghaem Teaching Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurosurgery, Ghaem Teaching Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
World Neurosurg. 2019 Jun;126:e492-e499. doi: 10.1016/j.wneu.2019.02.077. Epub 2019 Feb 28.
Disorders related to opioid use account for the most substantial burden of disease attributable to drug use disorders. We aimed to justify if there is an association between either opium consumption or addiction and rupture of intracranial aneurysms.
In this case-control study, we enrolled 50 cases with ruptured intracranial aneurysms and 43 control subjects with an incidental finding of an intracranial aneurysm without history of subarachnoid hemorrhage (SAH). Four major risk factors of rupture including age, sex, size, and site of aneurysm were matched among both groups. All participants were asked about cigarette smoking state, opium addiction, opium consumption, and duration and route of opium consumption. Eight other trigger factors were assessed in the period soon before SAH (hazard period). The odds ratio (OR) of all factors was calculated separately, and then a logistic regression for the factors with significant odds was calculated.
Sixty-two percent of cases and 32.6% of control subjects were addicted to opium. The OR for opium consumption in the hazard period was 8.1 (95% confidence interval [CI], 2.2-30.1) and for opium addiction was 3.3 (95% CI, 1.4-7.9). Of those trigger factors, cola consumption was included in the logistic regression model. After adjustment, results demonstrated an OR of 9.2 (95% CI, 2.4-34.7) for opium consumption in the hazard period.
There is an association between opium addiction and opium consumption in the hazard period with the occurrence of aneurysmal SAH. Replication of the study with a larger sample size and conduction of prospective studies is suggested.
与阿片类药物使用相关的疾病是药物使用障碍所致疾病负担中最为沉重的部分。我们旨在探究鸦片吸食或成瘾与颅内动脉瘤破裂之间是否存在关联。
在这项病例对照研究中，我们纳入了50例颅内动脉瘤破裂患者以及43例偶然发现颅内动脉瘤但无蛛网膜下腔出血（SAH）病史的对照者。两组在年龄、性别、动脉瘤大小和部位这四个主要的破裂风险因素上进行了匹配。所有参与者均被询问吸烟状况、鸦片成瘾情况、鸦片吸食情况以及鸦片吸食的持续时间和途径。在SAH发生前的短时间内（危险期）评估了其他八个触发因素。分别计算所有因素的比值比（OR），然后对具有显著比值的因素进行逻辑回归分析。
62%的病例和32.6%的对照者对鸦片成瘾。危险期鸦片吸食的OR为8.1（95%置信区间[CI]，2.2 - 30.1），鸦片成瘾的OR为3.3（95%CI，1.4 - 7.9）。在这些触发因素中，饮用可乐被纳入逻辑回归模型。调整后，结果显示危险期鸦片吸食的OR为9.2（95%CI，2.4 - 34.7）。
在危险期，鸦片成瘾和鸦片吸食与动脉瘤性SAH的发生之间存在关联。建议采用更大样本量重复该研究并开展前瞻性研究。
