Too much of a bad thing: Discharge opioid prescriptions in pediatric appendectomy patients.
J Pediatr Surg
; 53(12): 2374-2377, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30241962
ABSTRACT
BACKGROUND:
Opioid misuse is a public health crisis in the United States. This study aimed to evaluate the discharge opioid prescription practices for pediatric simple appendectomy patients.METHODS:
A retrospective review of pediatric appendectomy patients at a tertiary children's hospital was conducted from October 2016 to January 2018. Only patients with simple appendicitis were included. Written opioid prescriptions were found in the electronic medical record (EMR) or through a statewide prescription monitoring database. All dosing data were converted to oral morphine equivalents (OMEs). Analysis of variance and logistic regression were used.RESULTS:
During the study, 590 patients underwent appendectomy, of which 371 (62.9%) were diagnosed as having simple acute appendicitis. The majority of patients were prescribed an opioid analgesic (62.5%). Demographics were similar between those who received opioids and those who did not. The OME prescribed per day (range 0.2 to 3.4â¯mg/kg/day) was highly variable as was duration of prescription (1 to 30â¯days). Odds of emergency department visit were 3.3 times higher (95% CI 1.3-8.2) in those who received opioids.CONCLUSION:
Postdischarge prescription practices for pediatric appendectomy are highly variable. Two-thirds of patients who received narcotics had a higher rate of complications. Greater scrutiny is required to optimize opioid stewardship. TYPE OF STUDY Retrospective comparative study. LEVEL OF EVIDENCE Level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Apendicectomia
/
Padrões de Prática Médica
/
Analgésicos Opioides
/
Morfina
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article