Department of Statistics, Suva (Swiss National Accident Insurance Fund), Lucerne, Switzerland.
Department of General Internal Medicine, University Hospital of Bern, Inselspital, Freiburgstrasse 18, 3010, Bern, Switzerland.
Sci Rep. 2024 Jan 23;14(1):1978. doi: 10.1038/s41598-024-52477-7.
Opioid use is only recommended in selected cases of musculoskeletal (MSK) injuries. We assessed factors associated with increased opioid use in MSK injuries. In a retrospective analysis of over four million workers with MSK injuries using the Swiss National Accident Insurance Fund (Suva) database, we analyzed risk factors by multivariate logistic regression. Injury severity was associated with pain medication, opioid, and strong opioid use. Whereas fractures, contusions, and ruptures had higher odds for any pain medication use, increased odds for strong opioids were observed in fractures, superficial injuries, and other injuries. Injuries of the shoulders, elbow, chest, back/spine, thorax, and pelvis/hips showed high odds for opioid use (odds ratio (OR) > 2.0). Injuries of the shoulders had higher odds for strong opioid use (OR 1.136; 95% CI 1.040-1.241). The odds for using strong opioids increased from 2008 OR 0.843 (95% confidence interval (CI) 0.798-0.891) to 2018 OR 1.503 (95% CI 1.431-1.578), compared to 2013. Injury severity, type of injury, and injured body parts influenced the use of pain medication and overall opioid use in musculoskeletal injuries. Strong opioids were more often used in fractures but also in superficial and other minor injuries, which indicates that other factors play a role when prescribing strong opioids.
阿片类药物仅在特定的肌肉骨骼（MSK）损伤情况下推荐使用。我们评估了与 MSK 损伤中阿片类药物使用增加相关的因素。在使用瑞士国家意外保险基金（Suva）数据库对超过 400 万例 MSK 损伤患者进行的回顾性分析中，我们通过多变量逻辑回归分析了危险因素。损伤严重程度与止痛药、阿片类药物和强阿片类药物的使用相关。虽然骨折、挫伤和撕裂伤使用任何止痛药的几率更高，但骨折、浅表损伤和其他损伤使用强阿片类药物的几率增加。肩部、肘部、胸部、背部/脊柱、胸部和骨盆/臀部的损伤使用阿片类药物的几率较高（比值比（OR）>2.0）。肩部损伤使用强阿片类药物的几率更高（OR 1.136；95%CI 1.040-1.241）。与 2013 年相比，2008 年强阿片类药物的使用几率（OR 0.843；95%CI 0.798-0.891）降至 2018 年的 OR 1.503（95%CI 1.431-1.578）。损伤严重程度、损伤类型和受伤身体部位影响肌肉骨骼损伤中止痛药和总体阿片类药物的使用。强阿片类药物更多地用于骨折，但也用于浅表和其他轻微损伤，这表明在开具强阿片类药物时其他因素也起作用。
