1 Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
2 Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Cancer Control. 2019 Jan-Dec;26(1):1073274819871326. doi: 10.1177/1073274819871326.
Opioid use can induce immunosuppression; however, it is unclear whether opioid use increases infections in patients with advanced cancers. This study assessed the association between opioid use in the week before death and mortality among patients with advanced lung cancer having sepsis. Data on opioid usage in the week before death, general information, and clinical information of the patients were collected retrospectively. The primary outcome was the association between opioid use in the week before death and mortality after sepsis. The study included 980 patients who died of advanced lung cancer between January 2003 and June 2017 (sepsis related: 413, unrelated to sepsis: 567). The average morphine equivalent daily dose in the final week was higher in the sepsis group (313.5 ± 510.5 mg) than in the nonsepsis group (125.2 ± 246.9 mg, < .001). A significant association was found between the average morphine equivalent daily dose in the final week and mortality due to sepsis (odds ratio: 1.02, 95% confidence interval: 1.01-1.02, < .001). This was especially evident when the dose was increased by 10 mg in the final week. Furthermore, older age, male sex, and a lower body mass index were associated with an increased risk of mortality after developing sepsis. Opioid use in the week before death may be associated with mortality for patients with advanced lung cancer having sepsis.
阿片类药物的使用会导致免疫抑制；然而，尚不清楚阿片类药物的使用是否会增加晚期癌症患者的感染率。本研究评估了在有脓毒症的晚期肺癌患者死亡前一周使用阿片类药物与死亡率之间的关系。回顾性收集了死亡前一周阿片类药物使用、一般信息和患者临床信息的数据。主要结局是死亡前一周使用阿片类药物与脓毒症后死亡率之间的关系。该研究纳入了 980 名死于 2003 年 1 月至 2017 年 6 月之间的晚期肺癌患者（与脓毒症相关：413 例，与脓毒症无关：567 例）。在最后一周，脓毒症组的平均吗啡等效日剂量（313.5±510.5mg）高于非脓毒症组（125.2±246.9mg， <.001）。在最后一周的平均吗啡等效日剂量与因脓毒症导致的死亡率之间存在显著相关性（优势比：1.02，95%置信区间：1.01-1.02， <.001）。当最后一周剂量增加 10mg 时，这种相关性更为明显。此外，年龄较大、男性和较低的体重指数与发生脓毒症后死亡率增加相关。死亡前一周使用阿片类药物可能与患有脓毒症的晚期肺癌患者的死亡率相关。
