Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX.
Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX.
Medicine (Baltimore). 2024 Sep 13;103(37):e39743. doi: 10.1097/MD.0000000000039743.
In this study, we analyze the relationship between polypharmacy and surgical treatment in a population at a single teaching institution. The design of the study is a case-control analysis of hip fractures. The setting is at a single teaching institution located in Galveston, Texas, USA. Over a 5-year period, we conducted a retrospective review of patients within our medical record who underwent surgery for a hip fracture, identified by current procedural terminology codes 27235 and 27236. Our primary variable was a prescription of opioids, benzodiazepines, or both 30 days preoperatively and surgery performed. The main outcome measures were prescription of controlled medications and surgical class. We used descriptive analysis to summarize each variable as mean or frequency for continuous and categorical variables and subsequently assessed the association between demographic variables and drug prescription and surgical class. Of the 378 patients who met our inclusion criteria, 68.0% were females and 32.0% were males. The average age was 77.8 years. Most patients had a displaced hip fracture (61%). Most patients underwent a hip hemiarthroplasty (233, 61.6%) versus either a closed reduction with percutaneous pinning (125, 33.1%) or hip open reduction internal fixation (20, 5.3%). There was no significant difference between polypharmacy and hip fracture surgery; however, reported alcohol use was significant in both groups. In our patient population, opioid and/or benzodiazepine prescriptions were not significantly linked to hip fracture surgery, but documented alcohol use was found to be significant in both groups. We noted a higher prevalence of opioid and benzodiazepine prescriptions than was previously reported. As patients age, we should be cautious about the effects of polypharmacy and alcohol use and their impacts on the elderly.
在这项研究中，我们分析了一个单教学机构人群中药物过多和手术治疗之间的关系。该研究的设计是对髋关节骨折的病例对照分析。研究地点是位于美国德克萨斯州加尔维斯顿的一个单一教学机构。在 5 年期间，我们对我们的病历中接受髋关节骨折手术的患者进行了回顾性审查，这些患者通过当前手术术语代码 27235 和 27236 确定。我们的主要变量是术前 30 天内开具的阿片类药物、苯二氮䓬类药物或两者的处方以及手术的进行。主要结果指标是开处方的受控药物和手术类别。我们使用描述性分析来总结每个变量，对于连续和分类变量，分别以平均值或频率表示，然后评估人口统计学变量与药物处方和手术类别之间的关联。在符合我们纳入标准的 378 名患者中，68.0%为女性，32.0%为男性。平均年龄为 77.8 岁。大多数患者患有移位性髋关节骨折（61%）。大多数患者接受髋关节半髋关节置换术（233 例，61.6%），而接受闭合复位经皮钢针固定术（125 例，33.1%）或髋关节切开复位内固定术（20 例，5.3%）的患者较少。药物过多与髋关节骨折手术之间没有显著差异；然而，两组患者的报告饮酒量均有显著差异。在我们的患者人群中，阿片类药物和/或苯二氮䓬类药物的处方与髋关节骨折手术没有显著关联，但在两组患者中都发现了有记录的饮酒量的显著差异。我们注意到阿片类药物和苯二氮䓬类药物的处方比以前报道的更为普遍。随着患者年龄的增长，我们应该谨慎对待药物过多和酒精使用的影响及其对老年人的影响。
