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儿科院前阿片类药物使用情况与社会脆弱性的比较

A Comparison of Pediatric Prehospital Opioid Encounters and Social Vulnerability.

作者信息

Sandelich Stephen, Cavaliere Garrett, Buresh Christopher, Boehmer Susan, Glasser Joshua, Klansek Ian, Tolpin Aaron

机构信息

Department of Emergency Medicine, Penn State College of Medicine, Pennsylvania State University, Hershey, Pennsylvania.

Department of Emergency Medicine, University of Washington, Seattle, Washington.

出版信息

Prehosp Emerg Care. 2025;29(4):351-360. doi: 10.1080/10903127.2024.2424335. Epub 2024 Nov 8.

Abstract

OBJECTIVES

This study explores the relationship between socioeconomic factors and pediatric opioid-related emergencies requiring naloxone administration in the prehospital setting, an escalating public health concern.

METHODS

A retrospective analysis of the National Emergency Medical Services Information System (NEMSIS) database was conducted, examining data from pediatric opioid-related EMS activations between January 2018 and December 2021. The Social Vulnerability Index (SVI) was used to gauge each incident's socioeconomic context and assess correlations between SVI scores and the likelihood of opioid-related activations and naloxone interventions.

RESULTS

A total of 7,789 pediatric opiate-related EMS activations were identified. Lower socioeconomic status (SES) areas (higher SVI scores) exhibited a decreased rate of opioid-related activations compared to lower SVI-scored areas but an increased frequency of naloxone administration. The analysis demonstrated that as socioeconomic status (SES) improves, the likelihood of opioid-related activations increases significantly supported by a significant negative linear trend (Estimate = -0.2971, SE = 0.1172, z = -2.54,  = 0.0112. On the other hand, naloxone administration was more frequently required in lower SES areas, suggesting an increased emergency response in these (Estimate = 0.05806, SE = 0.2403,  = 0.24,  = 0.8091).

CONCLUSIONS

The analysis highlights a statistically significant correlation between the SES of an area and pediatric opioid-related EMS activations, yet an inverse correlation with the likelihood of naloxone administration. These findings demonstrate that in lower socioeconomic areas, the total number of opiate-related EMS activations is lower; however, naloxone was more likely to be deployed during those activations. This underscores the need for further research to understand the disparities in opioid crisis management across different socioeconomic landscapes.

摘要

目的

本研究探讨社会经济因素与院前环境中需要使用纳洛酮治疗的儿科阿片类药物相关紧急情况之间的关系,这是一个日益严重的公共卫生问题。

方法

对国家紧急医疗服务信息系统(NEMSIS)数据库进行回顾性分析,检查2018年1月至2021年12月期间儿科阿片类药物相关紧急医疗服务启动的数据。社会脆弱性指数(SVI)用于衡量每个事件的社会经济背景,并评估SVI分数与阿片类药物相关启动及纳洛酮干预可能性之间的相关性。

结果

共识别出7789次儿科阿片类药物相关紧急医疗服务启动。与社会脆弱性指数得分较低的地区相比,社会经济地位较低(SES)的地区(社会脆弱性指数得分较高)阿片类药物相关启动率较低,但纳洛酮使用频率较高。分析表明,随着社会经济地位(SES)的提高,阿片类药物相关启动的可能性显著增加,显著的负线性趋势对此提供了支持(估计值=-0.2971,标准误=0.1172,z=-2.54,P=0.0112)。另一方面,社会经济地位较低的地区更频繁地需要使用纳洛酮,这表明在这些地区应急反应增加(估计值=0.05806,标准误=0.2403,P=0.24,z=0.8091)。

结论

分析突出了一个地区的社会经济地位与儿科阿片类药物相关紧急医疗服务启动之间存在统计学上的显著相关性,但与纳洛酮使用的可能性呈负相关。这些发现表明,在社会经济地位较低的地区,阿片类药物相关紧急医疗服务启动的总数较低;然而,在这些启动过程中更有可能部署纳洛酮。这强调了需要进一步研究,以了解不同社会经济背景下阿片类药物危机管理的差异。

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