TY - JOUR
T1 - Persistent opioid use after surgical treatment of paediatric fracture
AU - Zhong, Haoyan
AU - Ladenhauf, Hannah N.
AU - Wilson, Lauren A.
AU - Liu, Jiabin
AU - DelPizzo, Kathryn R.
AU - Poeran, Jashvant
AU - Memtsoudis, Stavros G.
N1 - Publisher Copyright:
© 2021 British Journal of Anaesthesia
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - fracture
KW - opioid prescription
KW - orthopaedic surgery
KW - paediatrics
KW - persistent opioid use
KW - surgical reduction
UR - http://www.scopus.com/inward/record.url?scp=85101590427&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2020.12.044
DO - 10.1016/j.bja.2020.12.044
M3 - Article
C2 - 33640119
AN - SCOPUS:85101590427
SN - 0007-0912
VL - 126
SP - 1192
EP - 1199
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 6
ER -