钙通道阻滞剂联合各种阿片类药物对高血压心脏手术患者住院时间的不同影响：MIMIC-IV数据库分析
Differential effects of calcium channel blockers combined with various opioids on length of stay in hypertensive cardiac surgery patients: analysis of the MIMIC-IV database.
摘要(中文译文)
钙通道阻滞剂（CCB）与阿片类药物联合给药在接受心脏手术的高血压患者中较为常见。本研究旨在探讨CCB与不同阿片类药物联合使用与该人群住院时间（LOS）之间的关联。本回顾性研究纳入来自MIMIC-IV数据库的2，093例接受心脏手术的高血压成年患者。通过单因素logistic回归和LASSO回归系统筛选潜在协变量。随后，采用广义线性模型（GLM）和多因素logistic回归分析评估不同CCB-阿片类药物组合与LOS之间的关联。为进一步探讨异质性，进行了亚组分析和交互作用分析。GLM显示，与单用CCB相比，CCB与吗啡（β = 4.354，95%CI：2.535-6.173）、羟考酮（β = 2.418，95%CI：0.943-3.893）和曲马多（β = 2.382，95%CI：1.340-3.427）联合使用与LOS延长显著相关。值得注意的是，在这三种阿片类药物中，CCB-羟考酮组合在大多数校正logistic回归模型中均显示与住院时间延长具有稳健关联。亚组分析发现了显著的交互作用（交互作用P < 0.001），表明CCB-羟考酮与LOS延长的关联在接受瓣膜手术的患者和CCI评分 > 5的患者中明显更强。CCB与羟考酮联合给药与高血压心脏手术患者LOS延长稳健相关。这些发现凸显了个体化镇痛策略的必要性，以降低药物相互作用风险。
Abstract
The co-administration of calcium channel blockers (CCB) and opioids is common in hypertensive patients undergoing cardiac surgery. This study aimed to investigate the association between combinations of CCB with different opioids and length of stay (LOS) in this population. This retrospective study included 2,093 hypertensive adult patients who underwent cardiac surgery, drawn from the MIMIC-IV database. Potential covariates were systematically screened through univariate logistic regression and LASSO regression. Subsequently, generalized linear model (GLM) and multivariable logistic regression analyses were employed to evaluate the association between different CCB-opioids combinations and LOS. To further explore heterogeneity, subgroup analyses and interaction analyses were conducted. GLM revealed that the concomitant use of CCB with morphine (β = 4.354, 95%CI: 2.535-6.173), oxycodone (β = 2.418, 95%CI: 0.943-3.893), and tramadol (β = 2.382, 95%CI: 1.340-3.427) was significantly associated with prolonged LOS compared to CCB use alone. Notably, among these three opioid drugs, the CCB-oxycodone combination showed a robust association with prolonged hospital stay across the majority of adjusted logistic regression models. Subgroup analyses identified significant interaction effects (P for interaction < 0.001), showing that the association between CCB-oxycodone and extending LOS was substantially stronger in patients undergoing valve surgery and those with a CCI score > 5. Co-administration of CCB and oxycodone is robustly associated with prolonged LOS in hypertensive cardiac surgery patients. These findings highlight the necessity of individualized analgesic strategies to mitigate drug interaction risks.
如何引用
AMA
Xinglu Li, Haitao Liu, Qian Lin, Yuanhui Zhang. Differential effects of calcium channel blockers combined with various opioids on length of stay in hypertensive cardiac surgery patients: analysis of the MIMIC-IV database.. BMC cardiovascular disorders. 2026; doi:10.1186/s12872-026-06042-x.
APA
Xinglu Li, Haitao Liu, Qian Lin, Yuanhui Zhang (2026). Differential effects of calcium channel blockers combined with various opioids on length of stay in hypertensive cardiac surgery patients: analysis of the MIMIC-IV database.. BMC cardiovascular disorders. https://doi.org/10.1186/s12872-026-06042-x
GB/T 7714
Xinglu Li, Haitao Liu, Qian Lin, Yuanhui Zhang. Differential effects of calcium channel blockers combined with various opioids on length of stay in hypertensive cardiac surgery patients: analysis of the MIMIC-IV database.[J]. BMC cardiovascular disorders, 2026 doi:10.1186/s12872-026-06042-x.
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