Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Copenhagen Phase IV unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Basic Clin Pharmacol Toxicol. 2022 Jul;131(1):83-92. doi: 10.1111/bcpt.13741. Epub 2022 May 17.
Tramadol is a commonly used opioid with a potential of addiction and abuse. Using Danish nationwide registers, we aimed to (1) characterise opioid poisonings; (2) assess the 30-day mortality following morphine, oxycodone, and mixed poisonings compared to tramadol poisonings; and (3) assess the development in tramadol poisonings during a 12-year period. Poisonings were identified from 2006 to 2017. A Cox proportional hazards regression model was used to estimate adjusted hazard ratios (aHRs) along with 95% confidence intervals (CIs) for 30-day mortality following morphine, oxycodone or mixed poisonings compared to tramadol poisonings. We identified 7718 opioid poisonings among 6365 patients. The patients with a tramadol poisoning were younger and had less comorbidities than the patients with a morphine, oxycodone or mixed poisoning. Within 30 days, a total of 205 patients died. The 30-day mortality risk was higher following morphine (aHR 3.2, 95% CI 2.0-5.1), oxycodone (aHR 2.1, 95% CI 1.2-3.6) and mixed poisonings (aHR 1.6, 95% CI 1.0-2.7) compared to tramadol poisonings. The annual number of tramadol poisonings increased from 233 in 2006 to 501 in 2013 and declined to 348 in 2017. In conclusion, despite a lower mortality risk compared to other opioid poisonings, physicians should consider the poisoning and abuse risks when prescribing tramadol.
曲马多是一种常用的阿片类药物，具有成瘾和滥用的潜力。我们使用丹麦全国性登记处，旨在：（1）描述阿片类药物中毒情况；（2）评估吗啡、羟考酮和混合中毒与曲马多中毒相比的 30 天死亡率；（3）评估 12 年期间曲马多中毒的发展情况。中毒情况是从 2006 年至 2017 年确定的。使用 Cox 比例风险回归模型估计 30 天死亡率的调整后危险比（aHR）及其 95%置信区间（CI），吗啡、羟考酮或混合中毒与曲马多中毒相比。我们确定了 6365 名患者中的 7718 例阿片类药物中毒。曲马多中毒患者比吗啡、羟考酮或混合中毒患者年龄更小，合并症更少。在 30 天内，共有 205 名患者死亡。与曲马多中毒相比，吗啡（aHR 3.2，95%CI 2.0-5.1）、羟考酮（aHR 2.1，95%CI 1.2-3.6）和混合中毒（aHR 1.6，95%CI 1.0-2.7）的 30 天死亡率风险更高。曲马多中毒的年发病数从 2006 年的 233 例增加到 2013 年的 501 例，然后下降到 2017 年的 348 例。总之，尽管与其他阿片类药物中毒相比，曲马多中毒的死亡率风险较低，但医生在开曲马多时应考虑中毒和滥用的风险。
