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阿片类药物使用障碍与胃轻瘫患者的死亡率和发病率增加有关。

Opioid use disorder is associated with increased mortality and morbidity in patients with gastroparesis.

作者信息

Siddiqui Mohamed Tausif, Bilal Mohammad, Schorr-Lesnick Beth, Lebovics Edward, Dworkin Brad

机构信息

Department of Internal Medicine, New York Medical College, Valhalla, NY (Mohamed Tausif Siddiqui).

Department of Gastroenterology, University of Texas Medical Branch, Galveston, TX (Mohammad Bilal).

出版信息

Ann Gastroenterol. 2019 Jul-Aug;32(4):370-377. doi: 10.20524/aog.2019.0389. Epub 2019 May 22.

Abstract

BACKGROUND

Opioid use disorder (OUD) epidemic has been declared a nationwide public health emergency by the Department of Health and Human Services. There are limited data regarding OUD in patients with gastroparesis. This study aimed to evaluate the impact of OUD on the outcomes in patients hospitalized with gastroparesis and to delineate the trends associated with OUD and gastroparesis using a nationally representative sample.

METHODS

We used the National (Nationwide) Inpatient Sample database from 2005-2014 to identify patients hospitalized with a primary diagnosis of gastroparesis (ICD 9 Code: 536.3) and a concurrent diagnosis of OUD. We used Pearson chi-square analysis to compare demographics, the independent samples -test to assess differences in length of stay and cost of care, and multivariate regression analysis to adjust for confounders.

RESULTS

Between 2005 and 2014, a total of 145,700 patients with a primary diagnosis of gastroparesis were hospitalized in the United States, of whom 4519 (3.1%) had a concurrent diagnosis of OUD. The prevalence of OUD in gastroparesis doubled from 2.1% in 2005 to 4.3% in 2014. After adjusting for confounders, patients with OUD had greater in-hospital mortality (adjusted odds ratio 2.7, 95% confidence interval: 2.1-3.5). Patients with OUD also had significantly longer hospital stays and higher costs. Independent predictors of OUD in patients with gastroparesis were younger age, female sex, alcohol use, depression, and Medicaid insurance.

CONCLUSION

OUD in patients with gastroparesis is associated with greater mortality and healthcare resource utilization.

摘要

背景

美国卫生与公众服务部已宣布阿片类物质使用障碍(OUD)流行是一项全国性公共卫生紧急事件。关于胃轻瘫患者中OUD的数据有限。本研究旨在评估OUD对因胃轻瘫住院患者结局的影响,并使用具有全国代表性的样本描绘与OUD和胃轻瘫相关的趋势。

方法

我们使用2005年至2014年的全国(全美国)住院患者样本数据库,以识别原发性诊断为胃轻瘫(国际疾病分类第九版代码:536.3)且同时诊断为OUD的住院患者。我们使用Pearson卡方分析比较人口统计学特征,使用独立样本t检验评估住院时间和护理费用的差异,并使用多变量回归分析调整混杂因素。

结果

2005年至2014年期间,美国共有145,700例原发性诊断为胃轻瘫的患者住院,其中4519例(3.1%)同时诊断为OUD。胃轻瘫患者中OUD的患病率从2005年的2.1%翻倍至2014年的4.3%。在调整混杂因素后,OUD患者的院内死亡率更高(调整后的优势比为2.7,95%置信区间:2.1 - 3.5)。OUD患者的住院时间也显著更长,费用更高。胃轻瘫患者中OUD的独立预测因素为年龄较小、女性、饮酒、抑郁和医疗补助保险。

结论

胃轻瘫患者中的OUD与更高的死亡率和医疗资源利用相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ba7/6595927/a0495fbf0251/AnnGastroenterol-32-370-g002.jpg

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