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Persistent opioid use after surgical treatment of paediatric fracture

Haoyan Zhong1, Hannah N Ladenhauf2, Lauren A Wilson1

  • 1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.

British Journal of Anaesthesia
|February 28, 2021
PubMed

Insights

Over 21% of pediatric surgical fracture patients received opioid prescriptions, with 0.6% developing persistent opioid use. Identifying risk factors like older age and higher comorbidity burden is key to preventing long-term opioid dependence in children.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Public Health

Background:

  • The United States faces a significant opioid epidemic, with pediatric surgical patients frequently requiring pain management.
  • Fractures are a common reason for pediatric surgical intervention, necessitating careful examination of opioid use patterns.
  • Understanding opioid prescription patterns and identifying risk factors for persistent use in pediatric surgical patients is critical.

Purpose of the Study:

  • To characterize opioid prescription patterns in pediatric patients undergoing surgical fracture treatment.
  • To describe the epidemiology of single and persistent opioid use in this cohort.
  • To identify risk factors associated with persistent opioid use following pediatric fracture surgery.

Main Methods:

  • A retrospective, population-based cohort study was conducted.
  • National claims data from the Truven Health Analytics® MarketScan database were analyzed.
  • Opioid prescription patterns, epidemiology, and risk factors for persistent use were examined in pediatric patients treated for fractures.

Main Results:

  • 21.5% of 303,335 pediatric patients received at least one opioid prescription within six months post-surgery.
  • Persistent opioid use was observed in 1671 (0.6%) of the patients.
  • Risk factors for persistent opioid use included older age, female sex, lower extremity trauma, specific surgical sites (spine, rib cage, head), closed fracture treatment, earlier surgery dates, prior opioid use, and higher comorbidity burden.

Conclusions:

  • 21.5% of pediatric surgical fracture patients filled at least one opioid prescription, and 0.6% developed persistent opioid use.
  • Persistent opioid use was defined as filling a prescription between 3 and 6 months post-surgery.
  • Identifying specific risk factors can aid clinicians in developing targeted strategies to mitigate persistent opioid use in pediatric populations.
Abstract

Keywords:
fractureopioid prescriptionorthopaedic surgerypaediatricspersistent opioid usesurgical reduction

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