Discharge Opioid Prescriptions Following Pediatric Appendectomy: A NSQIP-P Study
Amna Minhas1, Humza Thobani2, Arsalan Javid3
1Loma Linda University Health, Department of General Surgery, Division of Pediatric Surgery, Loma Linda, CA, USA.
Journal of Pediatric Surgery
|July 19, 2025
Summary
Opioid prescriptions after pediatric appendectomy persist despite declining rates, with variations linked to patient demographics and imaging choices. Discharge opioids were associated with more emergency department visits but not readmissions.
Area of Science:
- Pediatric Surgery
- Pain Management
- Public Health
Background:
- Opioid prescribing patterns after pediatric appendectomy are not well understood.
- Variations in discharge opioid use may impact patient outcomes.
Purpose of the Study:
- To evaluate national trends in opioid prescriptions for pediatric appendectomy patients.
- To analyze the association between discharge opioid prescriptions and subsequent emergency department (ED) visits and readmissions.
Main Methods:
- Retrospective analysis of the National Surgical Quality Improvement Program - Pediatric (NSQIP-P) database (2023).
- Inclusion of pediatric patients (<18 years) undergoing appendectomy for simple or complicated appendicitis.
- Multivariable logistic regression to identify predictors of opioid prescribing and its association with ED visits and readmissions.
Main Results:
- 5.2% of 22,148 pediatric appendectomy patients received opioids at discharge.
- Predictors of opioid prescription included older age, male sex, Black/African American race, CT without ultrasound, and shorter hospital stay.
- Discharge opioids were associated with increased odds of ED visits (aOR 1.28) but not unplanned readmissions (aOR 1.13).
Conclusions:
- Significant variation in opioid prescribing persists following pediatric appendectomy.
- Patient demographics and imaging modality (CT vs. ultrasound) influence prescribing patterns.
- Optimizing pain management and reducing unnecessary opioid exposure are critical.
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