Borg Samantha J, Cameron Cate M, Luetsch Karen, Rolley Adam, Geraghty Timothy, McPhail Steven, McCreanor Victoria
Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Australia.
Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Herston, Australia.
J Spinal Cord Med. 2025 Mar;48(2):170-188. doi: 10.1080/10790268.2024.2319384. Epub 2024 Mar 11.
To determine the prevalence, reported harms and factors associated with opioid use among adults with spinal cord injury (SCI) living in the community.
Systematic review and meta-analysis.
Comprehensive literature searches were conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science and Scopus for articles published between 2000 and 2023. Risk of bias was assessed using a prevalence-specific tool. Random-effects meta-analyses were conducted to pool prevalence data for any context of opioids. Sensitivity and subgroup analyses were also performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study protocol was registered via Prospero (CRD42022350768).
Of the 4969 potential studies, 38 were included in the review. Fifty-three percent of studies had a low risk of bias, with a high risk of bias in 5% of studies. The pooled prevalence for the 38 studies included in the meta-analysis (total cohort size of 50,473) across any opioid context was 39% (95% confidence interval [CI], 32-47). High heterogeneity was evident, with a prediction interval twice as wide as the 95% CI (prediction interval, 7-84%). Mean or median opioid dose was unreported in 95% of studies. Opioid dose and factors related to opioids were also rarely explored in the SCI populations.
Results should be interpreted with caution based on the high heterogeneity and imprecise pooled prevalence of opioids. Contextual details including pain, cohort-specific injury characteristics and opioid dosage were inconsistently reported, indicating a clear need for additional studies in a population at greater risk of experiencing opioid-related adverse effects.
确定居住在社区的脊髓损伤（SCI）成年患者中阿片类药物使用的患病率、报告的危害及相关因素。
系统评价和荟萃分析。
在PubMed（MEDLINE）、EMBASE、CINAHL、Web of Science和Scopus中全面检索2000年至2023年发表的文章。使用特定患病率工具评估偏倚风险。进行随机效应荟萃分析以汇总任何阿片类药物使用情况下的患病率数据。还进行了敏感性和亚组分析。遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，并通过Prospero（CRD42022350768）注册研究方案。
在4969项潜在研究中，38项被纳入综述。53%的研究偏倚风险较低，5%的研究偏倚风险较高。纳入荟萃分析的38项研究（总队列规模为50473）在任何阿片类药物使用情况下的合并患病率为39%（95%置信区间[CI]，32 - 47）。明显存在高度异质性，预测区间是95%CI的两倍宽（预测区间，7 - 84%）。95%的研究未报告阿片类药物的平均或中位剂量。在脊髓损伤人群中，阿片类药物剂量及与阿片类药物相关的因素也很少被探讨。
鉴于阿片类药物的高度异质性和不精确的合并患病率，对结果的解释应谨慎。包括疼痛、特定队列损伤特征和阿片类药物剂量等背景细节报告不一致，表明显然需要对更易出现阿片类药物相关不良反应的人群进行更多研究。
