Opioid Overdose Risk Following Hospital Discharge Among Individuals Prescribed Long-Term Opioid Therapy: a Risk Interval Analysis.
Opioid Overdose Risk Following Hospital Discharge Among Individuals Prescribed Long-Term Opioid Therapy: a Risk Interval Analysis.
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处方长期阿片类药物疗法的患者出院后阿片类药物过量的风险：风险间隔分析。
DOI：
10.1007/s11606-022-08014-1
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发表时间：
2023-08
影响因子：
5.7
通讯作者：
Binswanger, Ingrid A.
中科院分区：
文献类型：
--
作者：
Lyden, Jennifer R.;Xu, Stanley;Narwaney, Komal J.;Glanz, Jason M.;Binswanger, Ingrid A.
接受长期阿片类药物治疗（LTOT）的个体出院后再次入院和死亡的风险增加。出院后立即服用阿片类药物过量的风险尚不清楚。旨在检查接受 LTOT 治疗的个体出院后的时间与阿片类药物过量之间的关系。自我控制风险区间分析。成年人在科罗拉多州的安全网卫生系统和非营利医疗组织中至少出院一次后开出 LTOT 处方。我们确定了 2006 年 1 月至 2019 年 6 月期间出院的接受 LTOT 治疗的个体。结果是出院后 90 天观察期内致命和非致命阿片类药物过量的综合结果，通过电子健康记录 (EHR) 和生命统计数据进行确定。风险区间包括指数发生后 0-6 天以及随后的出院。控制间隔范围为指数出院后第 7 天至第 89 天，包括观察期内不属于风险间隔的所有其他时间或随后住院期间重新入院的时间（排除在外）。泊松回归用于估计风险期间用药过量事件与对照区间相比的发生率比 (IRR) 和 95% 置信区间 (CI)。我们确定了 7695 名成年人（63.3% 年龄超过 55 岁，59.4% 女性，20.3% 西班牙裔）在研究期间总共经历了 9499 次出院。在他们的观察期间，发生了 21 起药物过量事件（每 10 万人年 1174 起[9 起处于危险状态，12 起处于控制状态]）。与对照区间相比，风险区间内的药物过量风险显着较高（IRR 6.92；95% CI 2.92-16.43）。在出院后的前 7 天内，接受 LTOT 治疗的个体阿片类药物过量的风险似乎较高。阐明过量风险的机制可能有助于为院内和出院后的预防策略提供信息。在线版本包含可在 10.1007/s11606-022-08014-1 获取的补充材料。
Individuals prescribed long-term opioid therapy (LTOT) have increased risk of readmission and death after hospital discharge. The risk of opioid overdose during the immediate post-discharge time period is unknown. To examine the association between time since hospital discharge and opioid overdose among individuals prescribed LTOT. Self-controlled risk interval analysis. Adults prescribed LTOT with at least one hospital discharge at a safety-net health system and a non-profit healthcare organization in Colorado. We identified individuals prescribed LTOT who were discharged from January 2006 through June 2019. The outcome was a composite of fatal and non-fatal opioid overdoses during a 90-day post-discharge observation period, identified using electronic health record (EHR) and vital statistics data. Risk intervals included days 0–6 after index and subsequent hospital discharges. Control intervals ranged from days 7 to 89 after index discharge and included all other time during the observation period that did not fall within a risk interval or time readmitted during a subsequent hospitalization, which was excluded. Poisson regression was used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for overdose events during risk in comparison to control intervals. We identified 7695 adults (63.3% over 55 years, 59.4% female, 20.3% Hispanic) who experienced 9499 total discharges during the study period. Twenty-one overdoses occurred during their observation periods (1174 per 100,000 person-years [9 in risk, 12 in control]). Overdose risk was significantly higher during the risk interval in comparison to the control interval (IRR 6.92; 95% CI 2.92–16.43). During the first 7 days after hospital discharge, individuals prescribed LTOT appear to be at elevated risk for opioid overdose. Clarifying mechanisms of overdose risk may help inform in-hospital and post-discharge prevention strategies. The online version contains supplementary material available at 10.1007/s11606-022-08014-1.
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影响因子：
--
作者：
Braden, Jennifer Brennan;Russo, Joan;Sullivan, Mark D.
通讯作者：
Sullivan, Mark D.
DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
3.7
作者：
Coffin, Phillip O.;Rowe, Christopher;Vittinghoff, Eric
通讯作者：
Vittinghoff, Eric
影响因子：
13.8
作者：
Glanz, Jason M.;Binswanger, Ingrid A.;Xu, Stan
通讯作者：
Xu, Stan
影响因子：
5.7
作者：
Glanz, Jason M.;Narwaney, Komal J.;Binswanger, Ingrid A.
通讯作者：
Binswanger, Ingrid A.