One year mortality of patients treated with naloxone for opioid overdose by emergency medical services.
One year mortality of patients treated with naloxone for opioid overdose by emergency medical services.
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DOI：
10.1080/08897077.2020.1748163
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Schuur JD , MD, MS
中科院分区：
文献类型：
--
作者：
Weiner SG , MD, MPH;Baker O , PhD;Bernson D , MPH;Schuur JD , MD, MS
近年来，由于目前阿片类药物过量流行，院前使用纳洛酮来推定阿片类药物过量的情况显着增加。在这项研究中，我们确定了疑似阿片类药物过量患者接受EMS治疗并最初存活的一年死亡率。这是一项使用马萨诸塞州三个相互关联的全州数据集对患者进行的回溯性观察性研究：紧急医疗服务(EMS)、人口统计学主文件和死亡记录。我们纳入了所有疑似阿片类药物过量的患者，他们都接受了EMS的纳洛酮治疗。主要的结果衡量标准是治疗后3天内和治疗后4天至1年内死亡。在2013年7月1日至2015年12月31日期间，有9734名符合纳入标准的个人被纳入分析。其中前3天死亡807例(8.3%，95%可信区间7.7%~8.8%)，4天至1年死亡668例(6.9%(95%可信区间6.4%~7.4%))，1年后存活8,259例(84.8%(95%可信区间84.1%~85.6%))。剔除那些在3天内死亡的人，其余8927人中有668人(7.5%(95%可信区间6.9%-8.0%))在一年内死亡。因EMS阿片类药物过量而接受纳洛酮治疗的患者的一年死亡率很高。社区应该把重点放在对这一患者群体的初级预防和干预上，包括加强区域治疗中心和扩大阿片类药物使用障碍的药物获得机会。
Prehospital use of naloxone for presumed opioid overdose has increased markedly in recent years because of the current opioid overdose epidemic. In this study, we determine the one-year mortality of suspected opioid overdose patients who were treated with naloxone by EMS and initially survived. This was a retrospective observational study of patients using three linked statewide datasets in Massachusetts: emergency medical services (EMS), a master demographics file, and death records. We included all suspected opioid overdose patients who were treated with naloxone by EMS. The primary outcome measures were death within 3 days of treatment and between 4 days and 1 year of treatment. Between July 1, 2013 and December 31, 2015, there were 9,734 individuals who met inclusion criteria and were included for analysis. Of these, 807 (8.3% (95% confidence interval (CI) 7.7%-8.8%)) died in the first 3 days, 668 (6.9% (95% CI 6.4%-7.4%)) died between 4 days and 1 year, and 8,259 (84.8% (95% CI 84.1%-85.6%)) were still alive at one year. Excluding those who died within 3 days, 668 of the remaining 8,927 individuals (7.5% (95% CI 6.9%-8.0%)) died within one year. The one-year mortality of those who are treated with naloxone for opioid overdose by EMS is high. Communities should focus both on primary prevention and interventions for this patient population, including strengthening regional treatment centers and expanding access to medication for opioid use disorder.
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