Opportunities for Emergency Medical Services Intervention to Prevent Opioid Overdose Mortality.
Opportunities for Emergency Medical Services Intervention to Prevent Opioid Overdose Mortality.
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紧急医疗服务干预的机会，以防止阿片类药物过量死亡。
DOI：
10.1080/10903127.2020.1740363
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发表时间：
2021-03
影响因子：
2.4
通讯作者：
Herbert KM
中科院分区：
文献类型：
--
作者：
Barefoot EH;Cyr JM;Brice JH;Bachman MW;Williams JG;Cabanas JG;Herbert KM
阿片类药物危机是美国日益增长的死亡原因，可以通过创新方法来识别有致命阿片类药物过量风险的个人来缓解。我们检查了一组因阿片类药物过量死亡的个体的紧急医疗服务（EMS）使用情况，以确定潜在的干预机会。在2014年1月1日至2016年12月31日期间，在北卡罗来纳州一个大县因非故意阿片类药物过量死亡的个体进行了回顾性队列研究。从北卡罗来纳州生命记录获得的死亡记录与从县EMS系统获得的EMS患者护理记录相关联，以描述每位死者在死亡前一年的EMS遭遇。评估患者人口统计数据和急诊就诊情况，以确定可能针对干预的就诊特征。采用卡方检验和优势比来评价和表征EMS使用率差异的统计学意义。在研究期间因意外阿片类药物过量而死亡的218人中，30% （n=66）在死亡前一年使用过EMS， 17% （n=38）至少有一次在EMS中使用过药物或酒精（即“与药物相关的遭遇”）。平均死亡年龄为38岁（范围19-74岁），30%为女性，89%为白人，8%为黑人/非裔美国人。与EMS使用率较高相关的因素包括年龄（P< 0.001）、性别（P= 0.006）和种族（P< 0.001）。56-65岁的患者EMS使用率最高（47%），25岁以下和25 - 35岁的患者EMS使用率更高（分别为29%和20%）。使用EMS最常见的原因是“其他医疗”（27%）、“非创伤性疼痛”（20%）、“创伤性损伤”（16%）和“中毒/药物摄入”（14%）。33%的急诊记录了药物或酒精使用情况，22%的急诊报告了阿片类药物处方。近三分之一因意外过量服用阿片类药物而死亡的人在死亡前一年使用了紧急医疗服务，近五分之一的人与毒品有关。急诊治疗可能提供一个机会来识别有阿片类药物过量风险的个体，并最终降低过量死亡率。
The opioid crisis is a growing cause of mortality in the United States and may be mitigated by innovative approaches to identifying individuals at-risk of fatal opioid overdose. We examined Emergency Medical Services (EMS) utilization among a cohort of individuals who died from opioid overdose in order to identify potential opportunities for intervention. Individuals who died of unintentional opioid overdose in a large North Carolina county between 01/01/2014 and 12/31/2016 were studied in a retrospective cohort. Death records obtained from North Carolina Vital Records were linked to EMS patient care records obtained from the county EMS System in order to describe the EMS encounters of each decedent in the year preceding their death. Patient demographics and EMS encounters were assessed to identify encounter characteristics that may be targeted for intervention. Chi-square tests and odds ratios were used to evaluate and characterize the statistical significance of differences in EMS utilization. Of the 218 individuals who died from unintentional opioid overdose in the study interval, 30% (n=66) utilized EMS in the year before their death and 17% (n=38) had at least one EMS encounter with documented drug or alcohol use (i.e. “drug-related encounter”). The mean age at death was 38 (range 19–74) years, 30% were female, 89% were White, and 8% were Black/African American. Factors associated with higher incidence of EMS utilization included age (P<.001), gender (P=.006), and race (P<.001). Decedents aged 56–65 had the highest EMS utilization (47%) and patients aged <25 and 25–35 had more drug-related EMS encounters (29% and 20%, respectively). The most common reasons for EMS utilization were “other medical” (27%), “non-traumatic pain” (20%), “traumatic injury” (16%), and “poisoning/drug ingestion” (14%). Drug or alcohol use was documented by EMS in 33% of all encounters and an opioid prescription was reported in 22% of encounters. Nearly one-third of individuals who died from accidental opioid overdose utilized EMS in the year before their death and nearly one-fifth had a drug-related encounter. EMS encounters may present an opportunity to identify individuals at-risk of opioid overdose and, ultimately, reduce overdose mortality.
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影响因子：
1.8
作者：
Maeng, Daniel D.;Han, John J.;Boscarino, Joseph A.
通讯作者：
Boscarino, Joseph A.
影响因子：
4.2
作者：
Darke, Shane;Mills, Katherine L.;Teesson, Maree
通讯作者：
Teesson, Maree
影响因子：
3.8
作者：
Stoove, Mark A.;Dietze, Paul M.;Jolley, Damien
通讯作者：
Jolley, Damien
影响因子：
4.4
作者：
Vilke, GM;Sloane, C;Chan, TC
通讯作者：
Chan, TC
DOI：
10.1097/00005373-200109000-00024
发表时间：
2001-09-01
影响因子：
--
作者：
Soderstrom, CA;Dischinger, PC;Scalea, TM
通讯作者：
Scalea, TM