阿片类药物使用障碍与脑动脉瘤破裂的关系

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-09-20 DOI:10.1016/j.drugalcdep.2025.112896

Fares Qeadan , Emma M. Federico , Benjamin Tingey , Atif Zafar , Andrew P. Carlson

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引用次数: 0

摘要

背景最近的研究表明阿片类药物使用障碍（OUD）与脑动脉瘤破裂之间存在关联。然而，这些研究仅限于小样本量，缺乏阿片类药物使用障碍（mod）药物的数据。我们在一个大型数据库中研究OUD与脑动脉瘤破裂之间的关系。方法采用Oracle EHR Real-World data™（OERWD）的去识别电子健康记录（EHR）数据进行回顾性队列研究。在不同的随访年限中，采用Cox比例风险回归来评估OUD与动脉瘤破裂之间的关系，以及OUD与动脉瘤破裂的关系。结果OUD患者（n = 584,125）与未暴露患者（n = 1752,375）相比，随访1年内发生脑动脉瘤破裂的风险（调整风险比（aHR）[95%可信区间（CI）]: 1.54[1.34, 1.76]）高出54%，随访5年内发生脑动脉瘤破裂的风险（aHR [95% CI]: 1.28[1.14, 1.44]）高出28%。此外，与接受OUD和mod治疗的患者（n = 83,164）相比，OUD但未接受mod治疗的患者（n = 410,466），随访1年脑动脉瘤破裂风险降低25% (aHR [95% CI]: 0.75[0.55, 1.01])，随访5年脑动脉瘤破裂风险降低30% （aHR [95% CI]: 0.70[0.51, 0.98]）。结论本研究确定OUD是脑动脉瘤破裂的重要危险因素，而mud是脑动脉瘤破裂的重要保护因素，且在一定随访年限内具有显著性或接近显著性。这些结果提供了重要的见解，可以鼓励未来有针对性的策略，早期干预和预防这些患者。

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The association of opioid use disorder with cerebral aneurysm rupture

Background

The association between opioid use disorder (OUD) and cerebral aneurysm rupture has been suggested in recent studies. However, these studies are limited to small sample sizes and lack data on medications for opioid use disorder (MOUD). We investigate the association between OUD and cerebral aneurysm rupture in a large database.

Methods

A retrospective cohort study was conducted using de-identified electronic health record (EHR) data from Oracle EHR Real-World Data™ (OERWD). Cox proportional hazard regressions were conducted to assess the association between OUD and aneurysm rupture, and the association of MOUD with aneurysm rupture, over different years of follow-up.

Results

Patients with OUD (n = 584,125), compared to non-exposures (n = 1752,375) had 54 % higher risk (adjusted hazard ratio (aHR) [95 % confidence interval (CI)]: 1.54 [1.34, 1.76]) of cerebral aneurysm rupture within one year of follow-up and 28 % higher risk (aHR [95 % CI]: 1.28 [1.14, 1.44]) within five years of follow-up. Additionally, patients with OUD and MOUD treatment (n = 83,164), compared to those with OUD but without MOUD (n = 410,466), had 25 % lower risk (aHR [95 % CI]: 0.75 [0.55, 1.01]) of cerebral aneurysm rupture in one year of follow-up and 30 % lower risk (aHR [95 % CI]: 0.70 [0.51, 0.98]) in five years of follow-up.

Conclusions

This research identified OUD as a significant risk factor, and MOUD as a protective factor both significant and on the boundary of significance in certain years of follow-up for cerebral aneurysm rupture. These results provide important insight that could encourage future targeted strategies for early intervention and prevention in such patients.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.