Skip to main content

Advertisement

Springer Nature Link
Log in

Risk factors associated with recent opioid-related hospitalizations in children: a nationwide analysis

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

Identifying at-risk children can provide a crucial opportunity for preventative measures to avoid opioid addiction. This study sought to determine at-risk pediatric patients that were previously hospitalized due to other causes prior to their opioid-related admission.

Methods

The Nationwide Readmissions Database (2010–2014) was queried for children 1–18 years old with an opioid-related hospitalization. Previous admissions (up to 1 year prior) and associated diagnoses were compared. Results were weighted for national estimates.

Results

51,349 opioid-related hospitalizations were identified with an overall in-hospital mortality of 0.8%. Seventeen percent had a previous admission during the same calendar year of which 44% had > 1 and 11% had ≥ 5 prior admissions. Only 4% of prior admissions occurred at a different hospital. Males and females were equally represented, and 82% were ≥ 13 years old. Only 16% of previously admitted patients underwent a major surgical procedure during a previous hospitalization. The most common concomitant diagnoses for patients with prior hospitalizations were drug abuse (37%), chronic pulmonary disease (18%), and depression (10%).

Conclusion

Opioid-related hospitalizations often occur among children with multiple recent admissions, usually to the same hospital. Most patients do not have a history of cancer or recent surgery to account for their opioid use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Kolodny A, Courtwright DT, Hwang CS et al (2015) The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annu Rev Public Health 36:559–574. https://doi.org/10.1146/annurev-publhealth-031914-122957

    Article  PubMed  Google Scholar 

  2. Gaither JR, Leventhal JM, Ryan SA, Camenga DR (2016) National trends in hospitalizations for opioid poisonings among children and adolescents, 1997 to 2012. JAMA Pediatr 170:1195–1201. https://doi.org/10.1001/jamapediatrics.2016.2154

    Article  PubMed  PubMed Central  Google Scholar 

  3. Harbaugh CM, Lee JS, Hu HM et al (2018) Persistent opioid use among pediatric patients after surgery. Pediatrics 141:e20172439. https://doi.org/10.1542/peds.2017-2439

    Article  PubMed  Google Scholar 

  4. Knipper E, Banta-Green CJ, Jimenez N (2017) Opioid use disorder and misuse: a review of the epidemiology and medical implications for pediatric anesthesiologists. Paediatr Anaesth 27:1070–1076. https://doi.org/10.1111/pan.13225

    Article  PubMed  Google Scholar 

  5. Tadros A, Layman SM, Davis SM et al (2016) Emergency department visits by pediatric patients for poisoning by prescription opioids. Am J Drug Alcohol Abuse 42:550–555. https://doi.org/10.1080/00952990.2016.1194851

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gaither JR, Shabanova V, Leventhal JM (2018) US national trends in pediatric deaths from prescription and illicit opioids, 1999–2016. JAMA Netw Open 1:e186558. https://doi.org/10.1001/jamanetworkopen.2018.6558

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kozlowski LJ, Kost-Byerly S, Colantuoni E et al (2014) Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Manag Nurs 15:22–35. https://doi.org/10.1016/j.pmn.2012.04.003

    Article  PubMed  Google Scholar 

  8. American Academy of Pediatrics, Committee on Psychosocial Aspects of Child and Family Health, Task Force on Pain in Infants, Children, and Adolescents (2001) The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 108:793–797. https://doi.org/10.1542/peds.108.3.793

    Article  Google Scholar 

  9. McGrath PA (1996) Development of the World Health Organization guidelines on cancer pain relief and palliative care in children. J Pain Symptom Manage 12:87–92. https://doi.org/10.1016/0885-3924(96)00099-1

    Article  CAS  PubMed  Google Scholar 

  10. Friedrichsdorf SJ, Kang TI (2007) The management of pain in children with life-limiting illnesses. Pediatr Clin North Am 54(645–672):x. https://doi.org/10.1016/j.pcl.2007.07.007

    Article  Google Scholar 

  11. Cravero JP, Agarwal R, Berde C et al (2019) The Society for Pediatric Anesthesia recommendations for the use of opioids in children during the perioperative period. Paediatr Anaesth 29:547–571. https://doi.org/10.1111/pan.13639

    Article  PubMed  PubMed Central  Google Scholar 

  12. Van Cleve WC, Grigg EB (2017) Variability in opioid prescribing for children undergoing ambulatory surgery in the United States. J Clin Anesth 41:16–20. https://doi.org/10.1016/j.jclinane.2017.05.014

    Article  PubMed  Google Scholar 

  13. Denning N-L, Kvasnovsky C, Golden JM et al (2019) Inconsistency in opioid prescribing practices after pediatric ambulatory hernia surgery. J Surg Res 241:57–62. https://doi.org/10.1016/j.jss.2019.03.043

    Article  PubMed  Google Scholar 

  14. Corona LE, Roth EB, Thao A et al (2021) Opioid prescribing is excessive and variable after pediatric ambulatory urologic surgery. J Pediatr Urol 17:259.e1-259.e6. https://doi.org/10.1016/j.jpurol.2021.01.008

    Article  Google Scholar 

  15. Dart RC, Surratt HL, Cicero TJ et al (2015) Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med 372:241–248. https://doi.org/10.1056/NEJMsa1406143

    Article  CAS  PubMed  Google Scholar 

  16. Manchikanti L, Fellows B, Ailinani H, Pampati V (2010) Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective. Pain Physician 13:401–435

    Article  Google Scholar 

  17. George JA, Park PS, Hunsberger J et al (2016) An Analysis of 34,218 pediatric outpatient controlled substance prescriptions. Anesth Analg 122:807–813. https://doi.org/10.1213/ANE.0000000000001081

    Article  PubMed  Google Scholar 

  18. Ahrari M, Ali S, Hartling L et al (2021) Nonmedical opioid use after short-term therapeutic exposure in children: a systematic review. Pediatrics 148:e2021051927. https://doi.org/10.1542/peds.2021-051927

    Article  PubMed  Google Scholar 

  19. Sun N, Steinberg BE, Faraoni D, Isaac L (2021) Variability in discharge opioid prescribing practices for children: a historical cohort study. Can J Anesth/J Can Anesth. https://doi.org/10.1007/s12630-021-02160-6

    Article  Google Scholar 

  20. Miech R, Johnston L, O’Malley PM et al (2015) Prescription opioids in adolescence and future opioid misuse. Pediatrics 136:e1169–e1177. https://doi.org/10.1542/peds.2015-1364

    Article  PubMed  PubMed Central  Google Scholar 

  21. McCabe SE, West BT, Boyd CJ (2013) Medical use, medical misuse, and nonmedical use of prescription opioids: results from a longitudinal study. Pain 154:708–713. https://doi.org/10.1016/j.pain.2013.01.011

    Article  PubMed  PubMed Central  Google Scholar 

  22. Osborne V, Striley CW, Nixon SJ et al (2019) Sex differences in patterns of prescription opioid non-medical use among 10–18 year olds in the US. Addict Behav 89:163–171. https://doi.org/10.1016/j.addbeh.2018.10.009

    Article  PubMed  Google Scholar 

  23. McCabe SE, Veliz P, Schulenberg JE (2016) Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: a national longitudinal study. Pain 157:2173–2178. https://doi.org/10.1097/j.pain.0000000000000624

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Overton HN, Hanna MN, Bruhn WE et al (2018) Opioid-prescribing guidelines for common surgical procedures: an expert panel consensus. J Am Coll Surg 227:411–418. https://doi.org/10.1016/j.jamcollsurg.2018.07.659

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rajbhandari-Thapa J, Zhang D, Padilla HM, Chung SR (2019) Opioid-related hospitalization and its association with chronic diseases: findings from the national inpatient sample, 2011–2015. Prev Chronic Dis 16:E157. https://doi.org/10.5888/pcd16.190169

    Article  PubMed  PubMed Central  Google Scholar 

  26. NRD Overview. https://www.hcup-us.ahrq.gov/nrdoverview.jsp. Accessed 14 Oct 2021

  27. Opioid Hospital Stays/Emergency Department Visits—HCUP Fast Stats. https://www.hcup-us.ahrq.gov/faststats/OpioidUseServlet. Accessed 14 Oct 2021

  28. Gryczynski J, Nordeck CD, Welsh C et al (2021) Preventing hospital readmission for patients with comorbid substance use disorder. Ann Intern Med 174:899–909. https://doi.org/10.7326/M20-5475

    Article  PubMed  Google Scholar 

  29. Nordeck CD, Welsh C, Schwartz RP et al (2018) Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service. Drug Alcohol Depend 186:23–28. https://doi.org/10.1016/j.drugalcdep.2017.12.043

    Article  PubMed  PubMed Central  Google Scholar 

  30. Welsh JW, Dennis ML, Funk R et al (2022) Trends and age-related disparities in opioid use disorder treatment admissions for adolescents and young adults. J Subst Abuse Treat 132:108584. https://doi.org/10.1016/j.jsat.2021.108584

    Article  PubMed  Google Scholar 

  31. Anderson KT, Bartz-Kurycki MA, Ferguson DM et al (2018) Too much of a bad thing: discharge opioid prescriptions in pediatric appendectomy patients. J Pediatr Surg 53:2374–2377. https://doi.org/10.1016/j.jpedsurg.2018.08.034

    Article  PubMed  Google Scholar 

  32. Cairo SB, Calabro KA, Bowdish E et al (2019) Variation in postoperative narcotic prescribing after pediatric appendectomy. J Pediatr Surg 54:1866–1871. https://doi.org/10.1016/j.jpedsurg.2018.11.015

    Article  PubMed  Google Scholar 

  33. Bedi P, Rai MP, Bumrah K et al (2021) Pattern and burden of opioid-related hospitalizations in the USA from 2016 to 2018. Br J Clin Pharmacol 87:4366–4374. https://doi.org/10.1111/bcp.14857

    Article  PubMed  Google Scholar 

  34. Wilson JD, Abebe KZ, Kraemer K et al (2021) Trajectories of opioid use following first opioid prescription in opioid-naive youths and young adults. JAMA Netw Open 4:e214552. https://doi.org/10.1001/jamanetworkopen.2021.4552

    Article  PubMed  PubMed Central  Google Scholar 

  35. Cho J, Kelley-Quon LI, Barrington-Trimis JL et al (2021) Behavioral health risk factors for nonmedical prescription opioid use in adolescence. Pediatrics 148:e2021051451. https://doi.org/10.1542/peds.2021-051451

    Article  PubMed  Google Scholar 

  36. Edlund MJ, Forman-Hoffman VL, Winder CR et al (2015) Opioid abuse and depression in adolescents: results from the National Survey on Drug Use and Health. Drug Alcohol Depend 152:131–138. https://doi.org/10.1016/j.drugalcdep.2015.04.010

    Article  PubMed  Google Scholar 

  37. Valentine SL, Nadkarni VM, Curley MAQ, Pediatric Acute Lung Injury Consensus Conference Group (2015) Nonpulmonary treatments for pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 16:S73-85. https://doi.org/10.1097/PCC.0000000000000435

    Article  PubMed  Google Scholar 

  38. Chidambaran V, Olbrecht V, Hossain M et al (2014) Risk predictors of opioid-induced critical respiratory events in children: naloxone use as a quality measure of opioid safety. Pain Med 15:2139–2149. https://doi.org/10.1111/pme.12575

    Article  PubMed  Google Scholar 

  39. Shanahan L, Hill SN, Bechtiger L et al (2021) Prevalence and childhood precursors of opioid use in the early decades of life. JAMA Pediatr 175:276–285. https://doi.org/10.1001/jamapediatrics.2020.5205

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge all HCUP Data Partners contributing to HCUP, a list of which can be found at (https://www.hcup-us.ahrq.gov/db/hcupdatapartners.jsp). This research did not receive any specific grant from funding agencies in the public, commercial, or not for-profit sectors.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA

    Anthony Ferrantella, Carlos T. Huerta, Hallie J. Quiroz, Chad M. Thorson, Eduardo A. Perez & Juan E. Sola

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    Kirby Quinn

  3. Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, FL, USA

    Ana C. Mavarez

Authors
  1. Anthony Ferrantella
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Carlos T. Huerta
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Kirby Quinn
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Ana C. Mavarez
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Hallie J. Quiroz
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Chad M. Thorson
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Eduardo A. Perez
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Juan E. Sola
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

Study conception and design: AF, CTH, EAP, JES. Acquisition of data: AF, CTH, HJQ, KQ. Analysis and interpretation of data: CTH, HJQ, AF, CMT, JES, EAP, ACM. Drafting of manuscript: AF, CTH, HJQ, KQ, CMT, EAP, JES, ACM. Critical revision of manuscript: AF, CTH, CMT, EAP, JES.

Corresponding author

Correspondence to Juan E. Sola.

Ethics declarations

Conflict of interest

None.

Financial disclosures

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferrantella, A., Huerta, C.T., Quinn, K. et al. Risk factors associated with recent opioid-related hospitalizations in children: a nationwide analysis. Pediatr Surg Int 38, 843–851 (2022). https://doi.org/10.1007/s00383-022-05088-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-022-05088-0

Keywords