Department of Anaesthesia, Austin Hospital, Melbourne, Vic, Australia; Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital and University of Melbourne, Melbourne, Vic, Australia.
Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital and University of Melbourne, Melbourne, Vic, Australia.
Heart Lung Circ. 2022 Apr;31(4):602-609. doi: 10.1016/j.hlc.2021.08.022. Epub 2021 Oct 14.
To characterise short-term and long-term opioid prescription patterns after cardiac surgery.
DESIGN, SETTING AND PARTICIPANTS: We obtained data from a single Australian tertiary hospital from November 2012 to July 2019 and included 2,205 patients who underwent a primary cardiac surgical procedure.
The primary outcome was the dose of opioids at hospital discharge. Secondary outcomes included factors associated with high dose opioid prescriptions and persistent opioids use after cardiac surgery.
Overall, 76.4% of study patients were prescribed opioids at hospital discharge, with a median discharge prescription of 150 mg oral morphine equivalents. Moreover, 52.8% of discharge opioid prescriptions were as slow-release formulations and 60.0% of all discharge prescriptions were for patients who had received no opioids the day before discharge. In the subset of our patients with long-term data, 14.0% were still receiving opioids at 3-12 months after cardiac surgery.
In cardiac surgical patients, opioid prescriptions at discharge were common, most were at higher than recommended doses and more than half were slow-release formulations. Such prescription was associated with one in seven patients continuing to receive opioids 3-12 months after surgery.
描述心脏手术后短期和长期阿片类药物处方模式。
设计、地点和参与者：我们从 2012 年 11 月至 2019 年 7 月从澳大利亚一家三级医院获得数据，纳入了 2205 名接受主要心脏外科手术的患者。
主要结局是出院时阿片类药物的剂量。次要结局包括与高剂量阿片类药物处方和心脏手术后持续使用阿片类药物相关的因素。
总体而言，76.4%的研究患者在出院时开具了阿片类药物，出院时的中位数处方剂量为 150 毫克口服吗啡当量。此外，52.8%的出院阿片类药物处方为缓释制剂，60.0%的所有出院处方均为前一天未接受阿片类药物的患者开具。在我们具有长期数据的患者亚组中，14.0%的患者在心脏手术后 3-12 个月仍在接受阿片类药物治疗。
在心脏外科患者中，出院时开具阿片类药物的情况很常见，大多数剂量高于推荐剂量，超过一半为缓释制剂。这种处方与七分之一的患者在手术后 3-12 个月继续接受阿片类药物治疗有关。
