Chronic pain, opioid prescriptions, and mortality in Denmark: A population-based cohort study
Chronic pain, opioid prescriptions, and mortality in Denmark: A population-based cohort study
复制标题
DOI：
10.1016/j.pain.2014.07.006
复制
发表时间：
2014-12-01
期刊：
影响因子：
7.4
通讯作者：
Sjogren, Per
中科院分区：
文献类型：
--
作者：
Ekholm, Ola;Kurita, Geana Paula;Sjogren, Per
本研究旨在调查患有慢性非癌症疼痛的阿片类药物使用者因损伤和毒性/中毒导致的死亡，癌症发展和住院的风险。一项基于人群的队列研究共有13，127名成年人，他们在2000年或2005年参加了丹麦健康访谈调查，并通过登记进行了前瞻性随访，直至2011年底，根据是否存在慢性疼痛进行分类（即疼痛持续时间>= 6个月）和长期或短期使用阿片类药物（个人在过去一年中每月至少使用1次处方，持续6个月，以及在过去一年中至少使用1次处方）。长期阿片类药物使用者的全因死亡风险是无慢性疼痛个体的1.72倍（95%置信区间[CI] = 1.23-2.41）。死亡风险较低，但短期（1.36，95% CI = 1.07-1.72）和慢性疼痛非阿片类药物使用者（1.39，95% CI = 1.22-1.59）的死亡风险仍显著高于背景人群。长期使用阿片类药物与心血管和癌症死亡率之间没有统计学显著相关性。类阿片使用者中没有因事故或自杀而死亡的，尽管类阿片使用者受伤和中毒/中毒导致住院的风险高于无慢性疼痛的个人。在长期阿片类药物使用者中，全因死亡率的风险显著较高，但未观察到长期阿片类药物使用与特定原因死亡率之间存在明显关联。然而，阿片类药物的使用增加了受伤和毒性/中毒的风险，导致住院。(c)2014年国际疼痛研究协会。Elsevier B. V.出版，保留所有权利。
This study aimed to investigate the risk of death, development of cancer, and hospital inpatient admissions resulting from injuries and toxicity/poisoning among opioid users with chronic noncancer pain. A population-based cohort of 13,127 adults, who have participated in the Danish Health Interview Surveys in 2000 or 2005 and have been followed up prospectively by registers until the end of 2011, were classified according to the absence or presence of chronic pain (ie, pain lasting >= 6 months) and long-term or short-term opioid use (individuals using at least 1 prescription per month for 6 months in the previous year and at least 1 prescription in the previous year, respectively). The risk of all-cause mortality was 1.72 (95% confidence interval [CI] = 1.23-2.41) times higher among long-term opioid users than among individuals without chronic pain. The risk of death was lower, but still significantly higher in short-term (1.36, 95% CI = 1.07-1.72) and non-opioid users with chronic pain (1.39, 95% CI = 1.22-1.59) than in the background population. There was no statistically significant association between long-term opioid use and cardiovascular and cancer mortality. No deaths among opioid users were caused by accidents or suicides, although opioid users had higher risks of injuries and toxicity/poisoning resulting in hospital inpatient admissions than individuals without chronic pain. The risk of all-cause mortality was significantly higher among long-term opioid users, but no obvious associations between long-term opioid use and cause-specific mortality were observed. However, opioid use increased the risk of injuries and toxicity/poisoning resulting in hospital inpatient admissions. (c) 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.