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种族、族裔与癌症大腹部手术后阿片类药物的持续使用

Race, Ethnicity, and Sustained Opioid Use After Major Abdominal Surgery for Cancer.

作者信息

Owusu-Agyemang Pascal, Feng Lei, Cata Juan P

机构信息

Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA.

出版信息

J Pain Res. 2023 Nov 7;16:3759-3774. doi: 10.2147/JPR.S427411. eCollection 2023.

Abstract

PURPOSE

Sustained opioid use is a well-known complication after surgery. Our objective was to determine whether there is any association between a patient's race or ethnicity and the sustained use of opioids in the year following surgery. Opioid use over the initial 3, 6, and 12 postoperative months was categorized as "sustained early", persistent, and chronic, respectively.

PATIENTS AND METHODS

Single-institution retrospective study of adults (≥18 years) who had undergone open abdominal surgery for cancer. Multivariable logistic regression was used to evaluate the association between race/ethnicity and opioid use.

RESULTS

Of the 3523 patients included in the study, 2543 (72.2%) were non-Hispanic (NH) White, 476 (13.5%) were Hispanic or Latino, 262 (7.4%) were NH-Black, 186 (5.3%) were Asian, and 56 (1.6%) belonged to other racial or ethnic groups. The overall rates of sustained early, persistent, and chronic opioid use were 15.9%, 7.1%, and 2.6%, respectively. In the multivariable analysis, patient race/ethnicity was associated with sustained early postoperative opioid use (p-value=0.037), with Hispanics/Latinos having significantly higher odds than NH-Whites (OR = 1.382 [95% CI: 1.057-1.808]; p = 0.018). However, neither persistent nor chronic opioid use was associated with race/ethnicity (p = 0.697 and p = 0.443, respectively).

CONCLUSION

In this retrospective study of adults who had undergone open abdominal surgery, patient race/ethnicity was not consistently associated with the development of sustained opioid use over the first 12 postoperative months.

摘要

目的

持续使用阿片类药物是手术后一种众所周知的并发症。我们的目标是确定患者的种族或族裔与术后一年内持续使用阿片类药物之间是否存在任何关联。术后最初3个月、6个月和12个月的阿片类药物使用分别被归类为“早期持续”、持续和慢性使用。

患者和方法

对接受开放性腹部癌症手术的成年人(≥18岁)进行单机构回顾性研究。采用多变量逻辑回归来评估种族/族裔与阿片类药物使用之间的关联。

结果

纳入研究的3523例患者中,2543例(72.2%)为非西班牙裔(NH)白人,476例(13.5%)为西班牙裔或拉丁裔,262例(7.4%)为NH黑人,186例(5.3%)为亚洲人,56例(1.6%)属于其他种族或族裔群体。早期持续、持续和慢性阿片类药物使用的总体发生率分别为15.9%、7.1%和2.6%。在多变量分析中,患者种族/族裔与术后早期持续使用阿片类药物有关(p值=0.037),西班牙裔/拉丁裔的几率显著高于NH白人(OR = 1.382 [95% CI:1.057 - 1.808];p = 0.018)。然而,持续或慢性阿片类药物使用均与种族/族裔无关(分别为p = 0.697和p = 0.443)。

结论

在这项对接受开放性腹部手术的成年人的回顾性研究中,患者种族/族裔与术后前12个月持续使用阿片类药物的发生并非始终相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e823/10638919/46ac2fe7ad2e/JPR-16-3759-g0001.jpg

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