Persistent opioid use after surgical treatment of paediatric fracture

Haoyan Zhong, Hannah N. Ladenhauf, Lauren A. Wilson, Jiabin Liu, Kathryn R. DelPizzo, Jashvant Poeran, Stavros G. Memtsoudis

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The opioid epidemic is one of the most pressing public health crises in the USA. With fractures being amongst the most common reasons for a child to require surgical intervention and receive post-surgical pain management, characterisation of opioid prescription patterns and risk factors is critical. We hypothesised that the numbers of paediatric patients receiving opioids, or who developed persistent opioid use, are significant, and a number of risk factors for persistent opioid use could be identified. Methods: We conducted a retrospective population-based cohort study. National claims data from the Truven Health Analytics® MarketScan database were used to (i) characterise opioid prescription patterns and (ii) describe the epidemiology and risk factors for single use and persistent use of opioids amongst paediatric patients who underwent surgical intervention for fracture treatment. Results: Amongst 303 335 patients, 21.5% received at least one opioid prescription within 6 months after surgery, and 1671 (0.6%) developed persistent opioid use. Risk factors for persistent opioid use include older age; female sex; lower extremity trauma; surgeries involving the spine, rib cage, or head; closed fracture treatment; earlier surgery years; previous use of opioid; and higher comorbidity burden. Conclusions: Amongst a cohort of paediatric patients who underwent surgical fracture treatment, 21.5% filled at least one opioid prescription, and 0.6% (N=1671) filled at least one more opioid prescription between 3 and 6 months after surgery. Understanding risk factors related to persistent opioid use can help clinicians devise strategies to counter the development of persistent opioid use for paediatric patients.

Original languageEnglish
Pages (from-to)1192-1199
Number of pages8
JournalBritish Journal of Anaesthesia
Issue number6
StatePublished - Jun 2021


  • fracture
  • opioid prescription
  • orthopaedic surgery
  • paediatrics
  • persistent opioid use
  • surgical reduction


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