PDF(Pubmed)
Abstract：
UNASSIGNED: This study examined whether there is an association between opioid-related mortality and surgical procedures.
UNASSIGNED: A case-control study design using deceased controls compared individuals with and without opioid death and their exposure to common surgeries in the preceding 4 years. This population-based study used linked death and hospitalization databases in Canada (excluding Quebec) from January 01, 2008 to December 31, 2017. Cases of opioid death were identified and matched to 5 controls who died of other causes by age (±4 years), sex, province of death, and date of death (±1 year). Patients with HIV infection and alcohol-related deaths were excluded from the control group. Logistic regression was used to determine if there was an association between having surgery and death from an opioid-related cause by estimating the crude and adjusted odds ratios (ORs) with the corresponding 95% confidence interval (CI). Covariates included sociodemographic characteristics, comorbidities, and the number of days of hospitalization in the previous 4 years.
UNASSIGNED: We identified 11,865 cases and matched them with 59,345 controls. About 11.2% of cases and 12.5% of controls had surgery in the 4 years before their death, corresponding to a crude OR of 0.89 (95% CI: 0.83-0.94). After adjustment, opioid mortality was associated with surgical procedure with OR of 1.26 (95% CI: 1.17-1.36).
UNASSIGNED: After adjusting for comorbidities, patients with opioid mortality were more likely to undergo surgical intervention within 4 years before their death. Clinicians should enhance screening for opioid use and risk factors when considering postoperative opioid prescribing.
UNASSIGNED: A case-control study design using deceased controls compared individuals with and without opioid death and their exposure to common surgeries in the preceding 4 years. This population-based study used linked death and hospitalization databases in Canada (excluding Quebec) from January 01, 2008 to December 31, 2017. Cases of opioid death were identified and matched to 5 controls who died of other causes by age (±4 years), sex, province of death, and date of death (±1 year). Patients with HIV infection and alcohol-related deaths were excluded from the control group. Logistic regression was used to determine if there was an association between having surgery and death from an opioid-related cause by estimating the crude and adjusted odds ratios (ORs) with the corresponding 95% confidence interval (CI). Covariates included sociodemographic characteristics, comorbidities, and the number of days of hospitalization in the previous 4 years.
UNASSIGNED: We identified 11,865 cases and matched them with 59,345 controls. About 11.2% of cases and 12.5% of controls had surgery in the 4 years before their death, corresponding to a crude OR of 0.89 (95% CI: 0.83-0.94). After adjustment, opioid mortality was associated with surgical procedure with OR of 1.26 (95% CI: 1.17-1.36).
UNASSIGNED: After adjusting for comorbidities, patients with opioid mortality were more likely to undergo surgical intervention within 4 years before their death. Clinicians should enhance screening for opioid use and risk factors when considering postoperative opioid prescribing.
摘要：
■这项研究检查了阿片类药物相关死亡率和外科手术之间是否存在关联。
一项使用已故对照的病例对照研究设计，比较了有和没有阿片类药物死亡的个体以及他们在过去4年中暴露于普通手术的情况。这项基于人群的研究使用了2008年1月1日至2017年12月31日加拿大（不包括魁北克）的关联死亡和住院数据库。确定阿片类药物死亡病例，并与5名按年龄（±4岁）死于其他原因的对照组相匹配。性别,死亡省,和死亡日期（±1年）。HIV感染和酒精相关死亡的患者被排除在对照组之外。通过估算粗比值比和调整后比值比（ORs）以及相应的95％置信区间（CI），使用逻辑回归来确定手术与阿片类药物相关原因导致的死亡之间是否存在关联。协变量包括社会人口统计学特征，合并症,以及前4年的住院天数。
■我们确定了11,865例病例，并将其与59,345例对照进行了匹配。大约11.2％的病例和12.5％的对照组在死亡前4年进行了手术，对应于粗OR为0.89（95%CI：0.83-0.94）。调整后,阿片类药物死亡率与手术操作相关，OR为1.26（95％CI：1.17-1.36）。
■调整合并症后，阿片类药物死亡患者更有可能在死亡前4年内接受手术干预.在考虑术后阿片类药物处方时，临床医生应加强对阿片类药物使用和危险因素的筛查。
一项使用已故对照的病例对照研究设计，比较了有和没有阿片类药物死亡的个体以及他们在过去4年中暴露于普通手术的情况。这项基于人群的研究使用了2008年1月1日至2017年12月31日加拿大（不包括魁北克）的关联死亡和住院数据库。确定阿片类药物死亡病例，并与5名按年龄（±4岁）死于其他原因的对照组相匹配。性别,死亡省,和死亡日期（±1年）。HIV感染和酒精相关死亡的患者被排除在对照组之外。通过估算粗比值比和调整后比值比（ORs）以及相应的95％置信区间（CI），使用逻辑回归来确定手术与阿片类药物相关原因导致的死亡之间是否存在关联。协变量包括社会人口统计学特征，合并症,以及前4年的住院天数。
■我们确定了11,865例病例，并将其与59,345例对照进行了匹配。大约11.2％的病例和12.5％的对照组在死亡前4年进行了手术，对应于粗OR为0.89（95%CI：0.83-0.94）。调整后,阿片类药物死亡率与手术操作相关，OR为1.26（95％CI：1.17-1.36）。
■调整合并症后，阿片类药物死亡患者更有可能在死亡前4年内接受手术干预.在考虑术后阿片类药物处方时，临床医生应加强对阿片类药物使用和危险因素的筛查。
