Tejiram Shawn, Solomon Eve A, Sen Soman, Greenhalgh David G, Palmieri Tina L, Romanowski Kathleen S
The Burn Center, MedStar Washington Hospital Center, District of Columbia, USA.
University of California, Davis Health, Sacramento, USA.
J Burn Care Res. 2022 May 17;43(3):534-540. doi: 10.1093/jbcr/irac009.
Methamphetamine (MA) use is associated with lower socioeconomic status (SES) and increased opioid use. Though MA use itself has been linked to larger burn injuries and increased length of stay, studies examining the effect of SES on opioid use in this patient population remain limited. The aim of this work was to examine how both SES and/or MA use in burn patients affected discharge opioid requirements. Records of burn patients admitted to an ABA-verified burn center were reviewed from January 2016 to December 2017. Patients were grouped into MA-positive (MPOS) or negative (MNEG) groups based on admission urine toxicology screening. Pain scores, oral morphine opioid equivalents (OEs), and adjunct pain medication use reported within 24 hours of discharge were examined. SES was determined by zip code. No difference was found between MPOS and MNEG groups regarding discharge OEs (P = .4), OE/TBSA (P = .79), or pain score (P = .09). Low SES was more prevalent in MPOS patients (P < .0001) but low SES was not a predictor of discharge OEs (P = .7), OE/TBSA (P = .7), or pain score (P = .15). Discharge OEs and OE/TBSA requirements correlated with discharge pain score (P < .0001) and LOS (P < .01), but not SES. Multivariate linear regression found that MNEG status (P = .005), pain score (P < .0001), concurrent use of benzodiazepines and gabapentin (P < .001), but not low SES, were independently associated with increased OEs. Although lower SES was seen in patients using MA, SES was not associated with discharge opioid use or pain scores. Additional work will be necessary to determine factors affecting opioid use in this population.
使用甲基苯丙胺（MA）与较低的社会经济地位（SES）以及阿片类药物使用增加有关。尽管使用MA本身与更严重的烧伤和住院时间延长有关，但研究SES对该患者群体阿片类药物使用影响的研究仍然有限。这项工作的目的是研究烧伤患者的SES和/或MA使用如何影响出院时的阿片类药物需求。回顾了2016年1月至2017年12月入住经美国烧伤协会（ABA）认证的烧伤中心的烧伤患者记录。根据入院时的尿液毒理学筛查，将患者分为MA阳性（MPOS）或阴性（MNEG）组。检查出院后24小时内报告的疼痛评分、口服吗啡阿片类等效物（OE）和辅助性止痛药物使用情况。SES由邮政编码确定。MPOS组和MNEG组在出院时的OE（P = 0.4）、OE/体表面积（P = 0.79）或疼痛评分（P = 0.09）方面没有差异。低SES在MPOS患者中更为普遍（P < 0.0001），但低SES并不是出院时OE（P = 0.7）、OE/体表面积（P = 0.7）或疼痛评分（P = 0.15）的预测因素。出院时的OE和OE/体表面积需求与出院时的疼痛评分（P < 0.0001）和住院时间（P < 0.01）相关，但与SES无关。多变量线性回归发现，MNEG状态（P = 0.005）、疼痛评分（P < 0.0001）、同时使用苯二氮䓬类药物和加巴喷丁（P < 0.001），而不是低SES，与OE增加独立相关。尽管使用MA的患者SES较低，但SES与出院时的阿片类药物使用或疼痛评分无关。需要进一步的研究来确定影响该人群阿片类药物使用的因素。
