Background

Migraine treatment may mitigate migraine and associated pain in the perioperative period.

Objective

The aim of the study was to estimate the effect of perioperative acute and prophylactic migraine treatment on the risk of postoperative 30-day hospital readmission with an admitting diagnosis specifying any pain complaints among migraine patients.

Design

Electronic health records were analysed for 21,932 adult migraine patients undergoing surgery between 2005 and 2017 at Beth Israel Deaconess Medical Center and Massachusetts General Hospital in Boston, Massachusetts, USA.

Methods

Perioperative abortive migraine treatment was defined as guideline-recommended medication (triptan, ergotamine, acetaminophen, nonsteroidal anti-inflammatory drug) prescription after surgery, within 30 days after discharge and prior readmission. Perioperatively continued prophylactic migraine treatment was defined as prescription both prior to surgery and perioperatively for recommended medications (beta-blockers, antidepressants, antiepileptics, onabotulinumtoxin A).

Results

Overall, 10,921 (49.8%) patients received a prescription for abortive migraine drugs. Of these, 1.2% and 1.5% of patients with and without such prescription were readmitted for pain, respectively. Patients with abortive treatment had lower odds of pain-related readmission (adjusted odds ratio 0.63 [95% confidence interval 0.49–0.81]). Prophylactic migraine treatment showed no effect on pain-related readmission independently of acute treatment (adjusted odds ratio 0.97 [95% confidence interval 0.72–1.32]).

Conclusions

Migraine patients undergoing surgery with a perioperative prescription for abortive migraine drugs were at decreased risk of pain-related hospital readmission.

中文翻译：

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偏头痛治疗和偏头痛患者术后疼痛相关再入院的风险。

背景

偏头痛治疗可以减轻围手术期的偏头痛和相关疼痛。

客观的

该研究的目的是评估围手术期急性和预防性偏头痛治疗对术后 30 天再入院风险的影响，入院诊断明确了偏头痛患者的任何疼痛主诉。

设计

对 2005 年至 2017 年间在美国马萨诸塞州波士顿的贝斯以色列女执事医疗中心和马萨诸塞州总医院接受手术的 21,932 名成年偏头痛患者的电子健康记录进行了分析。

方法

围手术期流产偏头痛治疗定义为手术后、出院后 30 天内和之前再次入院时使用指南推荐的药物（曲坦类、麦角胺、对乙酰氨基酚、非甾体类抗炎药）处方。围手术期持续预防性偏头痛治疗被定义为手术前和围手术期推荐药物（β-受体阻滞剂、抗抑郁药、抗癫痫药、肉毒杆菌毒素 A）的处方。

结果

总体而言，10,921 (49.8%) 名患者收到了无效偏头痛药物的处方。其中，有和没有这种处方的患者分别有 1.2% 和 1.5% 因疼痛再次入院。治疗失败的患者与疼痛相关的再入院几率较低（调整后的优势比为 0.63 [95% 置信区间 0.49–0.81]）。与急性治疗无关，预防性偏头痛治疗对疼痛相关的再入院没有影响（调整后的优势比为 0.97 [95% 置信区间 0.72–1.32]）。

结论

接受围手术期流产偏头痛药物处方的偏头痛患者与疼痛相关的再入院风险降低。