Abstract：
BACKGROUND: Opioids are known to cause respiratory depression, aspiration, and to suppress the immune system. This study aimed to investigate the relationship between short- and long-term opioid use and the occurrence and clinical outcomes of pneumonia in South Korea.
METHODS: The data for this population-based retrospective cohort analysis were obtained from the South Korean National Health Insurance Service. The opioid user group consisted of those prescribed opioids in 2016, while the non-user group, who did not receive opioid prescriptions that year, was selected using a 1:1 stratified random sampling method. The opioid users were categorized into short-term (1-89 d) and long-term (≥90 d) users. The primary end point was pneumonia incidence from January 1, 2017-December 31, 2021, with secondary end points including pneumonia-related hospitalizations and mortality rates during the study period.
RESULTS: In total, 4,556,606 adults were enrolled (opioid group, 2,070,039). Opioid users had a 3% higher risk of pneumonia and an 11% higher risk of pneumonia requiring hospitalization compared to non-users. Short-term users had a 3% higher risk of pneumonia, and long-term users had a 4% higher risk compared to non-users (P < .001). Additionally, short-term users had an 8% higher risk of hospital-treated pneumonia, and long-term users had a 17% higher risk compared to non-users (P < .001).
CONCLUSIONS: Both short- and long-term opioid prescriptions were associated with higher incidences of pneumonia and hospital-treated pneumonia. In addition, long-term opioid prescriptions were linked to higher mortality rates due to pneumonia.
METHODS: The data for this population-based retrospective cohort analysis were obtained from the South Korean National Health Insurance Service. The opioid user group consisted of those prescribed opioids in 2016, while the non-user group, who did not receive opioid prescriptions that year, was selected using a 1:1 stratified random sampling method. The opioid users were categorized into short-term (1-89 d) and long-term (≥90 d) users. The primary end point was pneumonia incidence from January 1, 2017-December 31, 2021, with secondary end points including pneumonia-related hospitalizations and mortality rates during the study period.
RESULTS: In total, 4,556,606 adults were enrolled (opioid group, 2,070,039). Opioid users had a 3% higher risk of pneumonia and an 11% higher risk of pneumonia requiring hospitalization compared to non-users. Short-term users had a 3% higher risk of pneumonia, and long-term users had a 4% higher risk compared to non-users (P < .001). Additionally, short-term users had an 8% higher risk of hospital-treated pneumonia, and long-term users had a 17% higher risk compared to non-users (P < .001).
CONCLUSIONS: Both short- and long-term opioid prescriptions were associated with higher incidences of pneumonia and hospital-treated pneumonia. In addition, long-term opioid prescriptions were linked to higher mortality rates due to pneumonia.
摘要：
背景：已知阿片类药物会引起呼吸抑制，抽吸,抑制免疫系统.本研究旨在探讨韩国短期和长期使用阿片类药物与肺炎的发生和临床结局之间的关系。
方法：这项基于人群的回顾性队列分析的数据来自韩国国家健康保险局。阿片类药物使用者群体由2016年的处方阿片类药物组成，而非使用者群体，那一年没有接受阿片类药物处方的人，采用1：1分层随机抽样方法选择。阿片类药物使用者分为短期（1-89d）和长期（≥90d）使用者。主要终点是2017年1月1日至2021年12月31日的肺炎发病率，次要终点包括研究期间肺炎相关的住院和死亡率。
结果：总计，纳入了4,556,606名成年人(阿片类药物组，2,070,039）。与非使用者相比，阿片类药物使用者患肺炎的风险高3％，需要住院治疗的肺炎风险高11％。短期使用者患肺炎的风险高出3%,长期使用者的风险比非使用者高4%(P<.001).此外,短期使用者患医院治疗肺炎的风险高出8%，长期使用者的风险比非使用者高17%(P<.001).
结论：短期和长期阿片类药物处方均与肺炎和医院治疗的肺炎发病率较高相关。此外,长期阿片类药物处方与肺炎导致的较高死亡率有关.
方法：这项基于人群的回顾性队列分析的数据来自韩国国家健康保险局。阿片类药物使用者群体由2016年的处方阿片类药物组成，而非使用者群体，那一年没有接受阿片类药物处方的人，采用1：1分层随机抽样方法选择。阿片类药物使用者分为短期（1-89d）和长期（≥90d）使用者。主要终点是2017年1月1日至2021年12月31日的肺炎发病率，次要终点包括研究期间肺炎相关的住院和死亡率。
结果：总计，纳入了4,556,606名成年人(阿片类药物组，2,070,039）。与非使用者相比，阿片类药物使用者患肺炎的风险高3％，需要住院治疗的肺炎风险高11％。短期使用者患肺炎的风险高出3%,长期使用者的风险比非使用者高4%(P<.001).此外,短期使用者患医院治疗肺炎的风险高出8%，长期使用者的风险比非使用者高17%(P<.001).
结论：短期和长期阿片类药物处方均与肺炎和医院治疗的肺炎发病率较高相关。此外,长期阿片类药物处方与肺炎导致的较高死亡率有关.
