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癌症诊断前经常使用镇痛药与情绪障碍发生之间的关联。

Association between Regular Use of Analgesics before Cancer Diagnosis and Occurrence of Mood Disorders.

作者信息

Oh Hyun Sook, Noh Subin, Seo Hwa Jeong

机构信息

Department of Applied Statistics, School of Social Science, Gachon University, Seongnam 461-701, Republic of Korea.

Global Healthcare Research Institute, Gachon University, Seongnam 461-701, Republic of Korea.

出版信息

Nurs Rep. 2024 Jul 24;14(3):1828-1837. doi: 10.3390/nursrep14030136.

Abstract

We aimed to determine the relationship between the use of analgesics prescribed for pain management and the onset and progression of mood disorders using a large-scale cohort database. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for patient risk of developing mood disorders based on age, income, health-related variables, disease history, Charlson comorbidity index, and analgesics prescription behavior (Models 1-3). Additionally, we determined the risk of mood disorder occurrence by age group (Model 4) using a proportional hazards regression model. The age- and income-adjusted HR (Model 1) was 1.8275. The age-, income-, BMI-, and physical-activity-adjusted HR (Model 2) was 1.882. The fully adjusted HR (Model 3) was 1.698. Compared with no analgesic use, nonregular use (HR = 1.386) and regular use (HR = 1.698) was associated with a higher risk of mood disorders. Among patients older than 50 years, those who participated in physical activity (less than five days) had a lower risk of mood disorders than those who did not. This suggests that it may be useful for preventing mood disorders in older cancer survivors. A high risk of comorbidities and regular use of analgesics are risk factors for developing mood disorders. Therefore, our results suggest that cancer survivors with a high risk of comorbidities and a history of regular analgesic use should undergo careful psychiatric consultation.

摘要

我们旨在利用一个大规模队列数据库,确定用于疼痛管理的镇痛药使用与情绪障碍的发生及进展之间的关系。我们根据年龄、收入、健康相关变量、疾病史、查尔森合并症指数和镇痛药处方行为(模型1 - 3),计算了患者发生情绪障碍风险的风险比(HR)及95%置信区间(CI)。此外,我们使用比例风险回归模型,按年龄组确定情绪障碍发生的风险(模型4)。年龄和收入调整后的HR(模型1)为1.8275。年龄、收入、体重指数和身体活动调整后的HR(模型2)为1.882。完全调整后的HR(模型3)为1.698。与未使用镇痛药相比,不定期使用(HR = 1.386)和定期使用(HR = 1.698)与情绪障碍风险较高相关。在50岁以上的患者中,参加身体活动(少于五天)的患者发生情绪障碍的风险低于未参加的患者。这表明这可能有助于预防老年癌症幸存者的情绪障碍。合并症风险高和定期使用镇痛药是发生情绪障碍的风险因素。因此,我们的结果表明,合并症风险高且有定期使用镇痛药病史的癌症幸存者应接受仔细的精神科会诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f075/11348258/583cf1261c29/nursrep-14-00136-g001.jpg

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