阿片类药物滥用住院患者神经系统合并症的综述
Review of Neurologic Comorbidities in Hospitalized Patients With Opioid Abuse.
作者信息
Nelson Kevin R, Dolbec Katelyn, Watson William, Yuan Hanwen, Ibraheem Mam
机构信息
Department of Neurology (KRN, KD, WW, MI), University of Kentucky, Lexington; Department of Neurology (WW), Uniformed Services University, Bethesda, MD; Performance Analytics Center of Excellence (HY), University of Kentucky Health Care, Lexington; Department of Epidemiology (MI), University of Kentucky, Lexington; and Lexington VA Health Care System (Troy Bowling Campus) (MI), US Department of Veterans Affairs, KY.
出版信息
Neurol Clin Pract. 2021 Dec;11(6):527-533. doi: 10.1212/CPJ.0000000000001080.
PURPOSE OF REVIEW
To determine the prevalence and burden of neurologic comorbidities in hospitalized patients with opioid abuse.
RECENT FINDINGS
From 1 year of hospital discharges, 2,182 patients with opioid abuse were identified (prevalence 6.3%), with abuse greater among younger patients ( < 0.0001), women ( < 0.0001), Whites ( < 0.0001), and urban population ( = 0.028). Matching for age, sex, race, and urban-rural residence, 347 patients were reviewed, and 179 (52%) had a neurologic comorbidity. The comorbidities frequently overlapped and included encephalopathy (130), neuromuscular disorders (42), seizures (23), spine disorders (23), strokes (20), CNS infections (3), and movement disorders (2). Abuse patients with neurologic comorbidities experienced substantially greater number of hospital and intensive care unit days and mortality, independent of overdose.
SUMMARY
Neurologic comorbidities are a frequent and heretofore underappreciated contributor to the disease burden of hospitalized patients with opioid abuse. The importance of neurologic comorbidities should be included in the public health discussions surrounding the opioid epidemic.
综述目的
确定阿片类药物滥用住院患者中神经科合并症的患病率和负担。
最新发现
在1年的医院出院病例中，识别出2182例阿片类药物滥用患者（患病率6.3%），年轻患者（<0.0001）、女性（<0.0001）、白人（<0.0001）和城市人口（=0.028）中的滥用情况更为严重。在年龄、性别、种族和城乡居住地相匹配的情况下，对347例患者进行了审查，其中179例（52%）患有神经科合并症。这些合并症经常重叠，包括脑病（130例）、神经肌肉疾病（42例）、癫痫发作（23例）、脊柱疾病（23例）、中风（20例）、中枢神经系统感染（3例）和运动障碍（2例）。患有神经科合并症的滥用患者住院天数和重症监护病房天数以及死亡率显著更高，与过量用药无关。
总结
神经科合并症是阿片类药物滥用住院患者疾病负担中一个常见但迄今未得到充分认识的因素。神经科合并症的重要性应纳入围绕阿片类药物流行的公共卫生讨论中。
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