Prevalence of Chronic Opioid Use in the Elderly After Hip Fracture Surgery.
Prevalence of Chronic Opioid Use in the Elderly After Hip Fracture Surgery.
复制标题
髋部骨折手术后老年人长期使用阿片类药物的患病率。
DOI：
10.1016/j.arth.2022.01.071
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
S. Mears
中科院分区：
文献类型：
--
作者：
Timothy Hereford;Austin Porter;J. Stambough;Steven M. Cherney;S. Mears
研究背景虽然人们的兴趣集中在全髋关节置换术后阿片类药物的使用，但很少有研究调查髋部骨折后老年患者阿片类药物的使用。我们假设，大量的阿片类药物初治的老年患者在髋部骨折手术后继续长期使用阿片类药物。MethodsWe回顾了219例65岁及以上的患者的连续系列，这些患者在2016年1月1日至2019年2月28日期间接受了手术固定。因多发伤、假体周围或病理性骨折、近期接受大手术或髋关节手术后90天内死亡而被排除的患者。国家处方监测数据库被用来确定阿片类药物use.ResultsOverall，58例（26%）术后慢性阿片类药物使用者。在最初的188名阿片类药物初治患者中，43名（23%）成为慢性使用者。在31名术前阿片类药物使用者中，15名（48%）继续长期使用。慢性术后使用者更可能是白色人（76%vs91%，P = 0.04）、年轻人（78 vs82岁，P= 0.003）和术前阿片类药物使用者（优势比3.3，P = 0.007）。关节成形术与固定并没有影响慢性阿片类药物的使用率（P= 0.22）。23%的阿片类药物初治髋部骨折患者在手术后成为慢性使用者。骨科医生需要持续保持警惕，以限制术后麻醉剂处方的数量和持续时间，并监测是否继续使用。
BackgroundWhile interest has focused on opioid use after total hip arthroplasty, little research has investigated opioid use in elderly patients after hip fracture. We hypothesize that a substantial number of opioid-naïve elderly patients go on to chronic opioid use after hip fracture surgery.MethodsWe reviewed a consecutive series of 219 patients 65 years and older who underwent surgical fixation between January 1, 2016 and February 28, 2019 for a native hip fracture. Patients were excluded for polytrauma, periprosthetic or pathologic fractures, recent major surgery, or death within 90 days of their hip surgery. The state prescription monitoring database was used to determine opioid use.ResultsOverall, 58 patients (26%) were postoperative chronic opioid users. Of the initial 188 opioid-naïve patients, 43 (23%) became chronic users. Of the 31 preoperative opioid users, 15 (48%) continued as chronic users. Chronic postoperative users were more likely to be White (76% vs 91%,P= .04), younger (78 vs 82 years,P= .003), and preoperative opioid users (odds ratio 3.3,P= .007). Arthroplasty vs fixation did not affect the rate of chronic opioid use (P= .22).ConclusionChronic opioid use is surprisingly common after hip fracture repair in the elderly. Twenty-three percent of opioid-naïve hip fracture patients became chronic users after surgery. Continued vigilance is needed by orthopedic surgeons to limit the amount and duration of postoperative narcotic prescriptions and to monitor for continued use.
老年脆性骨折后 12 个月内阿片类药物的使用模式：一项基于人群的队列研究。
DOI：
10.1016/j.jamda.2018.09.024
发表时间：
2019
影响因子：
7.6
作者：
Torchia,MichaelT;Munson,Jeffrey;Tosteson,TorD;Tosteson,AnnaNA;Wang,Qianfei;McDonough,ChristineM;Morgan,TamaraS;Bynum,JuliePW;Bell,John-Erik
通讯作者：
Bell,John-Erik