Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study.
Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study.
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DOI：
10.1186/s13104-016-1974-x
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发表时间：
2016-03-15
影响因子：
1.8
通讯作者：
Delagarza V
中科院分区：
文献类型：
--
作者：
Rudisill TM;Zhu M;Davidov D;Leann Long D;Sambamoorthi U;Abate M;Delagarza V
当代老年人报告说，处方药、非处方药和娱乐性药物的终生使用率较高。本分析的目的是描述药物使用的特征，并确定≥65岁驾驶员人群中与个体药物相关的机动车碰撞风险。在西弗吉尼亚大学医疗保健机构进行了一项病例交叉研究，使用从2009年1月1日至2014年6月30日发生机动车碰撞后接受治疗的≥65岁驾驶员的电子健康记录（n = 611）中获得的数据。将患者在碰撞前14天的药物使用情况与碰撞前四个对照期的药物使用情况进行匹配和比较。然后使用条件logistic回归计算最常见的个体药物和药物亚类的比值比。止痛药、心血管药和胃肠药很常见。很少有司机对合法或非法药物检测呈阳性。在毒品检测呈阳性的人中，苯二氮卓类和阿片类药物占多数。服用曲马多的司机（调整后的OR 11.41; 95% CI 1.27，102.15）发生机动车碰撞的风险显著增加。有这种药物处方的老年驾驶员可能需要意识到潜在的风险。进一步的研究是必要的，在一个更大的，更具全国代表性的人口。
The current generation of older adults reports a higher lifetime prevalence of prescription, over-the-counter, and recreational drug use. The purpose of this analysis is to characterize the drug usage and determine the risk of motor vehicle collision associated with individual medications in a population of drivers ≥65 years. A case-crossover study was conducted at West Virginia University Healthcare’s facilities using data obtained from the electronic health records (n = 611) of drivers ≥65 years admitted for medical treatment following a motor vehicle collision which occurred between Jan. 1, 2009 and June 30, 2014. Patients’ medication usage 14 days before collision were matched and compared to their medication usage during four control periods prior to collision. Odds ratios were then calculated for the most prevalent individual medications and pharmaceutical sub-classes using conditional logistic regression. Analgesic, cardiovascular and gastrointestinal medicines were common. Few drivers tested positive for either licit or illicit drugs. Of those testing positive for drugs, benzodiazepines and opiates were prevalent. Drivers consuming Tramadol (adjusted OR 11.41; 95 % CI 1.27, 102.15) were at a significantly increased risk of motor vehicle collision. Older adult drivers who have a prescription for this medication may need to be aware of the potential risk. Further research is necessary in a larger, more nationally representative population.