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Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest



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  • Personal Author:
  • Description:
    Background: Despite increased national attention on misuse of prescription and nonprescription opioids for adolescents and children, little is known about opioid use in a pediatric population during hospitalization for injury. The purpose of this investigation is to describe opioid administration and magnitude of opioid exposure in the first 48 hours of hospitalization in a pediatric trauma population. Study design: This is a secondary analysis of data collected for a randomized, prospective intervention study at 4 Midwestern children's trauma centers. Participants included children ages 10 to 17 years old, admitted to the hospital for unintentional injury. Descriptive statistics and multivariable modeling were used to characterize demographic factors and measure prevalence and magnitude of opioid use within the first 48 hours of hospitalization. Results: Among 299 participants, 82% received at least 1 opioid administration. Children had increased odds of receiving an opioid (odds ratio [OR] 4.25; 95% CI 2.16 to 8.35) for every log increase of Injury Severity Scores (ISS), yet the majority of children with minor injury (61%) also received an opioid. Children with fractures and older children had higher odds of receiving an opioid. Amount of opioid, expressed as morphine milligrams equivalent (MME), significantly increased with child age, ISS, and fracture. Conclusions: Most pediatric trauma patients received an opioid in the first 48 hours of hospitalization, although prevalence and exposure varied by age, injury, and acuity. Aggressive pain management can be appropriate for injured pediatric patients; however, study results indicate areas for improvement, specifically for children with minor injuries and those receiving excessive opioid amounts. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    1072-7515
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Journal Article
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    404-414
  • Volume:
    229
  • Issue:
    4
  • NIOSHTIC Number:
    nn:20064527
  • Citation:
    J Am Coll Surg 2019 Oct; 229(4):404-414
  • Contact Point Address:
    Sarah K Spilman, MA, Trauma Services, UnityPoint Health, 1200 Pleasant St, Des Moines, IA 50309
  • Email:
    sarah.spilman@unitypoint.org
  • Federal Fiscal Year:
    2020
  • Performing Organization:
    University of Minnesota Twin Cities
  • Peer Reviewed:
    True
  • Start Date:
    20050701
  • Source Full Name:
    Journal of the American College of Surgeons
  • End Date:
    20250630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:aee14dc30dc4ba5d2f6557c5f838689139dbe8992027b583f762431aa0aa2c970f64d4c5ae5cff9ed3dc6d32c0b0ad3d07b87671c94d3c7b4135ac2684e5a071
  • Download URL:
  • File Type:
    Filetype[PDF - 428.56 KB ]
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