胰十二指肠切除术后阿片类药物初治患者阿片类药物长期使用的发生率和危险因素。

IF 2.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Fang-Ju Hsueh, Jin-Ming Wu, Chien-Hui Wu, Ting-Chun Kuo, Ching-Yao Yang, Kuang-Cheng Chan, Yu-Wen Tien
{"title":"胰十二指肠切除术后阿片类药物初治患者阿片类药物长期使用的发生率和危险因素。","authors":"Fang-Ju Hsueh, Jin-Ming Wu, Chien-Hui Wu, Ting-Chun Kuo, Ching-Yao Yang, Kuang-Cheng Chan, Yu-Wen Tien","doi":"10.1002/jhbp.70007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Effective pain management is essential for patients undergoing pancreaticoduodenectomy (PD) due to the complexity of the surgery. Opioid analgesics (OA) are commonly used for pain relief but can lead to prolonged postoperative use, posing significant health risks. This study examines the incidence and risk factors of prolonged OA use among opioid-naive patients following PD.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent PD from 2010 to 2022 at National Taiwan University Hospital, excluding those with preoperative opioid use, emergent PD, minimally invasive procedures, opioid dependence, or in-hospital death. Prolonged OA use was defined as filling at least one OA prescription between 31 and 60 days postoperatively. Statistical analyses included univariate and multivariate logistic regression models to identify risk factors.</p><p><strong>Results: </strong>Among the 1309 patients, 224 (17.1%) filled at least one OA prescription between 31 and 60 days after PD. Multivariate analysis identified BMI (OR = 1.06, 95% CI = 1.02-1.10, p = 0.001), chronic pancreatitis (OR = 1.82, 95% CI = 1.13-2.94, p = 0.013), and epidural analgesia use (OR = 2.40, 95% CI = 1.64-3.52, p < 0.001) as factors associated with prolonged OA use.</p><p><strong>Conclusion: </strong>This study reveals a 17.1% incidence of prolonged OA use among opioid-naive patients post-PD. These findings highlight the need for tailored pain management strategies to reduce prolonged opioid use and improve patient outcomes. Further research should focus on developing targeted interventions to mitigate opioid dependency in this population.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence and Risk Factors for Prolonged Opioid Analgesic Use in Opioid-Naive Patients Following Pancreaticoduodenectomy.\",\"authors\":\"Fang-Ju Hsueh, Jin-Ming Wu, Chien-Hui Wu, Ting-Chun Kuo, Ching-Yao Yang, Kuang-Cheng Chan, Yu-Wen Tien\",\"doi\":\"10.1002/jhbp.70007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Effective pain management is essential for patients undergoing pancreaticoduodenectomy (PD) due to the complexity of the surgery. Opioid analgesics (OA) are commonly used for pain relief but can lead to prolonged postoperative use, posing significant health risks. This study examines the incidence and risk factors of prolonged OA use among opioid-naive patients following PD.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent PD from 2010 to 2022 at National Taiwan University Hospital, excluding those with preoperative opioid use, emergent PD, minimally invasive procedures, opioid dependence, or in-hospital death. Prolonged OA use was defined as filling at least one OA prescription between 31 and 60 days postoperatively. Statistical analyses included univariate and multivariate logistic regression models to identify risk factors.</p><p><strong>Results: </strong>Among the 1309 patients, 224 (17.1%) filled at least one OA prescription between 31 and 60 days after PD. Multivariate analysis identified BMI (OR = 1.06, 95% CI = 1.02-1.10, p = 0.001), chronic pancreatitis (OR = 1.82, 95% CI = 1.13-2.94, p = 0.013), and epidural analgesia use (OR = 2.40, 95% CI = 1.64-3.52, p < 0.001) as factors associated with prolonged OA use.</p><p><strong>Conclusion: </strong>This study reveals a 17.1% incidence of prolonged OA use among opioid-naive patients post-PD. These findings highlight the need for tailored pain management strategies to reduce prolonged opioid use and improve patient outcomes. Further research should focus on developing targeted interventions to mitigate opioid dependency in this population.</p>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jhbp.70007\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jhbp.70007","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:由于胰十二指肠切除术(PD)手术的复杂性,有效的疼痛管理对患者至关重要。阿片类镇痛药(OA)通常用于缓解疼痛,但可能导致术后使用时间延长,造成重大健康风险。本研究探讨了PD后阿片类药物初始患者长期OA使用的发生率和危险因素。方法:本回顾性队列研究纳入2010年至2022年在国立台湾大学医院接受PD治疗的患者,不包括术前使用阿片类药物、急诊PD、微创手术、阿片类药物依赖或院内死亡的患者。延长OA使用定义为术后31至60天内至少服用一种OA处方。统计分析包括单变量和多变量逻辑回归模型,以确定危险因素。结果:1309例患者中,224例(17.1%)在PD后31 ~ 60天内至少服用了一种OA处方。多因素分析确定了BMI (OR = 1.06, 95% CI = 1.02-1.10, p = 0.001)、慢性胰腺炎(OR = 1.82, 95% CI = 1.13-2.94, p = 0.013)和硬膜外镇痛使用(OR = 2.40, 95% CI = 1.64-3.52, p)。这些发现强调需要量身定制的疼痛管理策略,以减少阿片类药物的长期使用并改善患者的预后。进一步的研究应侧重于制定有针对性的干预措施,以减轻这一人群的阿片类药物依赖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence and Risk Factors for Prolonged Opioid Analgesic Use in Opioid-Naive Patients Following Pancreaticoduodenectomy.

Background: Effective pain management is essential for patients undergoing pancreaticoduodenectomy (PD) due to the complexity of the surgery. Opioid analgesics (OA) are commonly used for pain relief but can lead to prolonged postoperative use, posing significant health risks. This study examines the incidence and risk factors of prolonged OA use among opioid-naive patients following PD.

Methods: This retrospective cohort study included patients who underwent PD from 2010 to 2022 at National Taiwan University Hospital, excluding those with preoperative opioid use, emergent PD, minimally invasive procedures, opioid dependence, or in-hospital death. Prolonged OA use was defined as filling at least one OA prescription between 31 and 60 days postoperatively. Statistical analyses included univariate and multivariate logistic regression models to identify risk factors.

Results: Among the 1309 patients, 224 (17.1%) filled at least one OA prescription between 31 and 60 days after PD. Multivariate analysis identified BMI (OR = 1.06, 95% CI = 1.02-1.10, p = 0.001), chronic pancreatitis (OR = 1.82, 95% CI = 1.13-2.94, p = 0.013), and epidural analgesia use (OR = 2.40, 95% CI = 1.64-3.52, p < 0.001) as factors associated with prolonged OA use.

Conclusion: This study reveals a 17.1% incidence of prolonged OA use among opioid-naive patients post-PD. These findings highlight the need for tailored pain management strategies to reduce prolonged opioid use and improve patient outcomes. Further research should focus on developing targeted interventions to mitigate opioid dependency in this population.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信