Mohan Minu Ponnamma, Epstein Joel B, Meleveedu Kapil S, Padhi Parikshit, Pili Roberto, Satheeshkumar Poolakkad S
ECMC Health Campus, 462 Grider St, University at Buffalo, Buffalo, NY 14215, USA.
City of Hope Comprehensive Cancer Center, Duarte CA and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical System, Los Angeles, CA 91010, USA.
Pharmaceuticals (Basel). 2025 Apr 6;18(4):536. doi: 10.3390/ph18040536.
: Mucositis is a debilitating side effect of cancer therapy that adversely affects quality of life, cost of care, and the outcome of cancer therapy. Oral mucositis-related pain may be treated with numerous modalities but often includes opioids. The effects of opiate treatment on painful UM and its overall influence on the burden of illness (BOI) in cancer patients remain unknown. This study utilized the 2017 United States (US) National Inpatient Sample (NIS) database. The exposure was opioid treatment for chemo-induced ulcerative mucositis (UM), oral mucositis-induced pain, and the main outcomes included in-hospital mortality and BOI, length of hospital stays (LOS), and total hospital charges. Multivariable regression analysis was used to examine the relationship between outcomes and the key independent variable, opioid use, adjusting for propensity scores. : In the propensity score-adjusted analysis, UM patients with opioid treatment had 0.51 times lower total charges (95% CI: 0.42-0.76) and 0.67 times shorter LOS (95% CI: 0.51-0.87) than the UM patients without opioid treatment. However, there was no association between opioid treatment and in-hospital mortality. In the sensitivity analysis, the effect estimates were comparable in the propensity score-adjusted analysis, the decile-adjusted model, and the full model with the non-propensity score estimated method. Cancer patients with chemotherapy-induced UM-prescribed opioid analgesics for treating pain are associated with a lower BOI. Opioid pain medications are commonly provided to cancer survivors; estimating the BOI among them is crucial in supportive care research.
黏膜炎是癌症治疗中一种使人衰弱的副作用，会对生活质量、护理成本和癌症治疗结果产生不利影响。与口腔黏膜炎相关的疼痛可以通过多种方式治疗，但通常包括使用阿片类药物。阿片类药物治疗对疼痛性口腔黏膜炎的影响及其对癌症患者疾病负担（BOI）的总体影响尚不清楚。本研究使用了2017年美国国家住院样本（NIS）数据库。暴露因素是针对化疗引起的溃疡性黏膜炎（UM）、口腔黏膜炎引起的疼痛进行的阿片类药物治疗，主要结局包括住院死亡率和疾病负担、住院时间（LOS）以及总住院费用。采用多变量回归分析来检验结局与关键自变量（阿片类药物使用）之间的关系，并对倾向得分进行调整。在倾向得分调整分析中，接受阿片类药物治疗的UM患者的总费用比未接受阿片类药物治疗的UM患者低0.51倍（95%置信区间：0.42 - 0.76），住院时间短0.67倍（95%置信区间：0.51 - 0.87）。然而，阿片类药物治疗与住院死亡率之间没有关联。在敏感性分析中，倾向得分调整分析、十分位数调整模型和采用非倾向得分估计方法的完整模型中的效应估计值具有可比性。因化疗引起UM而开具阿片类镇痛药物治疗疼痛的癌症患者的疾病负担较低。阿片类止痛药物通常会提供给癌症幸存者；在支持性护理研究中评估他们的疾病负担至关重要。
