The use of opioids in low acuity pediatric trauma patients
Autoři:
Ashley A. Foster aff001; John J. Porter aff001; Florence T. Bourgeois aff001; Rebekah Mannix aff001
Působiště autorů:
Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
aff001; Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
aff002; Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of America
aff003
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0226433
Souhrn
Objective
To describe temporal trends and factors associated with opioid administration among children discharged from the emergency department (ED) after a trauma visit.
Methods
This was a cross-sectional study of ED visits for children <19 years old who received a trauma-related diagnosis and were discharged from the ED. Data were obtained from the National Hospital Ambulatory Medical Care Survey 2006–2015.
Outcome measures
Administration of an opioid medication either during the ED visit or as a discharge prescription. Survey-adjusted regression analyses were used to determine the probability of a patient receiving an opioid medication.
Results
During the study period, there were 19,241 pediatric trauma visits discharged from the ED, of which 14% were associated with an opioid. Opioid administration decreased by nearly 30% during the study period (p<0.001 for trend). In multivariable analysis, patient factors associated with opioid administration were adolescent age, evening visit, region of the country, and severe pain score. The diagnosis associated with the most opioids was ankle sprain and the diagnosis with the highest rate of opioid administration was radius fracture. The most common opioid administered to children under 12 years of age was acetaminophen-codeine.
Conclusions
Opioid administration appears to be decreasing among pediatric patients presenting to the ED with trauma, but a high number of children continue to be exposed to opioids every year. Further education on opioid sparing pain management strategies may be warranted to decrease opioid exposure, including the inappropriate use of codeine, in this low risk trauma population.
Klíčová slova:
Adolescents – Bone fracture – Critical care and emergency medicine – Musculoskeletal injury – Opioids – Pediatrics – Traumatic injury – Codeine
Zdroje
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PLOS One
2019 Číslo 12
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