Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses - United States, July 2016-September 2017
Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses - United States, July 2016-September 2017
复制标题
DOI：
10.15585/mmwr.mm6709e1
复制
发表时间：
2018-03-09
影响因子：
33.9
通讯作者：
Coletta, Michael A.
中科院分区：
文献类型：
--
作者：
Vivolo-Kantor, Alana M.;Seth, Puja;Coletta, Michael A.
引言：2015年至2016年，阿片类药物过量致死人数增加了27.7%，这表明阿片类药物过量流行的情况在恶化，并凸显了快速收集、分析和传播数据的重要性。
方法：对2016年7月至2017年9月期间涉及阿片类药物过量的急诊科（ED）综合征数据和医院收费数据进行了研究。在地区层面以及按人口统计学特征分析了45个州的52个辖区内阿片类药物过量的时间趋势。为了根据城市发展评估趋势，按州和城市化水平对16个州的数据进行了分析。
结果：2016年7月至2017年9月，来自45个州的52个辖区共有142,557次急诊科就诊（每10,000次就诊中有15.7次）被怀疑是涉及阿片类药物的过量。该比率平均每季度增加5.6%。在各个人口群体以及美国所有五个地区，该比率均有所上升，其中西南部、中西部和西部的增长幅度最大（每季度约7% - 11%）。在16个州，有119,198次急诊科就诊（每10,000次就诊中有26.7次）被怀疑是涉及阿片类药物的过量。从2016年第三季度到2017年第三季度，10个州（特拉华州、伊利诺伊州、印第安纳州、缅因州、密苏里州、内华达州、北卡罗来纳州、俄亥俄州、宾夕法尼亚州和威斯康星州）的季度比率显著上升，而在一个州（肯塔基州），该比率显著下降。比率上升幅度最高的是大型中心都市区。
结论及对公共卫生实践的启示：随着阿片类药物过量情况的持续增加，及时获取数据对于为急诊科和公共卫生从业者采取行动提供信息至关重要。阿片类药物过量的增加因地区和城市化水平而异，这表明需要有针对性的本地化应对措施。对急诊科医生和工作人员进行有关即时护理和治疗的适当服务的教育，并实施包括提供纳洛酮以及将患者与治疗相联系的药物过量后处理方案，有助于急诊科预防药物过量。
Introduction: From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination.Methods: Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016-September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics. To assess trends based on urban development, data from 16 states were analyzed by state and urbanization level.Results: From July 2016 through September 2017, a total of 142,557 ED visits (15.7 per 10,000 visits) from 52 jurisdictions in 45 states were suspected opioid-involved overdoses. This rate increased on average by 5.6% per quarter. Rates increased across demographic groups and all five U.S. regions, with largest increases in the Southwest, Midwest, and West (approximately 7%-11% per quarter). In 16 states, 119,198 ED visits (26.7 per 10,000 visits) were suspected opioid-involved overdoses. Ten states (Delaware, Illinois, Indiana, Maine, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, and Wisconsin) experienced significant quarterly rate increases from third quarter 2016 to third quarter 2017, and in one state (Kentucky), rates decreased significantly. The highest rate increases occurred in large central metropolitan areas.Conclusions and Implications for Public Health Practice: With continued increases in opioid overdoses, availability of timely data is important to inform actions taken by EDs and public health practitioners. Increases in opioid overdoses varied by region and urbanization level, indicating a need for localized responses. Educating ED physicians and staff members about appropriate services for immediate care and treatment and implementing a post-overdose protocol that includes naloxone provision and linking persons into treatment could assist EDs with preventing overdose.