Patel Aneesh, Levi Jessica R, Brook Christopher D
Boston University School of Medicine, Boston, MA, USA.
Department of Otolaryngology, Boston University Medical Center, Boston, MA, USA.
Ann Otol Rhinol Laryngol. 2020 Feb;129(2):164-169. doi: 10.1177/0003489419880576. Epub 2019 Oct 4.
The objective of this study was to determine whether patients with rhinitis medicamentosa (RM) have an increased odds of having an opioid use disorder (OUD) and which characteristics may predict this association.
The authors conducted a retrospective case control study of patients 18 years and older who presented to the otolaryngology clinic at an academic medical center from January 2013 through December 2017. Cases, defined as patients who presented with excessive decongestant nasal spray usage based on history, were matched to control patients who presented with chronic rhinitis and did not report regular nasal decongestant usage. The charts were reviewed for patients that carried a problem of opioid abuse, identified using ICD-9 codes 304.XX or ICD-10 codes F11.XX. The primary outcome of this study was the odds of having an OUD. Secondary outcomes were assessed by summary statistics.
One hundred and thirty-one cases of RM were matched to 1871 controls of chronic rhinitis. Seven cases (5.3%) and 24 (1.3%) controls had a diagnosis of OUD, consistent with an odds ratio of 3.98 for opioid abuse in patients with RM (95% CI: 1.47-9.71). Oxymetazoline was used by 85.5% (n = 112) of patients with RM. Thirty-six patients (27.1%) with RM underwent nasal surgery following a diagnosis of RM, of which twenty patients (55.6%) were prescribed opioids following the procedure.
RM is associated with increased odds of having an OUD.
本研究的目的是确定药物性鼻炎（RM）患者患阿片类药物使用障碍（OUD）的几率是否增加，以及哪些特征可能预测这种关联。
作者对2013年1月至2017年12月在一所学术医疗中心耳鼻喉科门诊就诊的18岁及以上患者进行了一项回顾性病例对照研究。根据病史，将因使用过量减充血剂鼻喷雾剂就诊的患者定义为病例组，与患有慢性鼻炎且未报告经常使用鼻减充血剂的对照组患者进行匹配。查阅病历，以确定存在阿片类药物滥用问题的患者，使用ICD-9编码304.XX或ICD-10编码F11.XX进行识别。本研究的主要结局是患OUD的几率。次要结局通过汇总统计数据进行评估。
131例RM患者与1871例慢性鼻炎对照组患者进行了匹配。7例（5.3%）病例组患者和24例（1.3%）对照组患者被诊断为OUD，这与RM患者阿片类药物滥用的比值比为3.98一致（95%CI：1.47-9.71）。85.5%（n=112）的RM患者使用了羟甲唑啉。36例（27.1%）RM患者在被诊断为RM后接受了鼻腔手术，其中20例（55.6%）患者在手术后被开具了阿片类药物。
RM与患OUD的几率增加有关。
