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Master Thesis

Broncho-pneumopathie chronique obstructive et douleur aiguë : les opiacés en question(s) ?

Abstract : Pain seems to be a common symptom in chronic obstructive pulmonary disease (COPD). However, a barrier to opioids prescription could be the fear of respiratory depression which is a known adverse event. The purpose of this study was to assess strong opioids prescription in COPD patients with acute pain. This is a retrospective cohort study of 83119 patients admitted in the Emergency Department (ED) of University hospital centers of Grenoble and Sacré-Coeur hospital of Montréal. Patients (≥40 years) admitted from Mars 2008 to September 2014 for abdominal pain, traumatism, or dyspnea, were included. Propensity score (PS) was calculated for all patients through a multiple logistic regression model, to evaluate the risk (Odds ratio) of strong opioids prescription in COPD. Among 83119 patients analysed, 7800 (9.4%) had COPD. Mean age was 68 years (53-81). In patients with a visual analogue scale pain assessment ≥ 6, COPD patients received less opioids than other patients (35.6% vs 42.7%, p<.001). Median time of opioids attribution was longer in COPD (2h31 vs 2h06, p<.001). After propensity score in multivariate analysis, COPD patients did not received less often opioids (OR 0.90, IC95% 0.78-1.02, p=.10). A simple logistic regression established the Odds Ratio for intubation or intensive care unit (ICU) transfer at 0.45 (IC95% 0.19-1.06, p=.07) and 1.31 (IC95% 0.93-1.87, p=.13), respectively. COPD patients do not receive less often strong opioids than other patients. Getting opioids for acute pain in ED is not significantly associated with more morbidity.
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Master Thesis
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Submitted on : Monday, November 16, 2015 - 4:23:28 PM
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  • HAL Id : dumas-01229458, version 1


Caroline Faivre-Pierret. Broncho-pneumopathie chronique obstructive et douleur aiguë : les opiacés en question(s) ?. Médecine humaine et pathologie. 2015. ⟨dumas-01229458⟩



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