[Pharmwaste] Opioid-Related Critical Care Resource Use in US Children’s Hospitals

Ed Gottlieb EGottlieb at cityofithaca.org
Mon Mar 5 09:03:55 EST 2018


"The number of opioid-related hospitalizations requiring PICU [pediatric intensive care unit] care doubled between 2004 and 2015."
"Current efforts to reduce adult opioid use have not curtailed the incidence of pediatric opioid ingestions, and additional efforts are needed to reduce preventable opioid exposure in children."
Abstract

BACKGROUND AND OBJECTIVES: There has been a rapid increase in the rate of pediatric opioid-related hospitalizations. It is unknown how this increase has impacted the use of pediatric critical care. Our objective in this study was to assess the trends in pediatric hospitalization for opioid ingestions in a cohort of US children’s hospitals and, specifically, to evaluate the impact on pediatric critical care resource use.

METHODS: A retrospective cohort study of the Pediatric Health Information System was performed to identify hospitalizations for opioid ingestions from 2004 to 2015. Admission to the PICU and the use of naloxone, vasopressors, and ventilation were assessed by using billing data. The primary outcome measure was the trend in the rate of PICU admission for opioid-related ingestion over time, assessed by using Poisson regression.

RESULTS: There were 3647 opioid-related hospitalizations in 31 hospitals; 42.9% required PICU care. The overall mortality was 1.6%, with annual deaths decreasing from 2.8% to 1.3% (P < .001). The number of opioid-related hospitalizations requiring PICU care doubled between 2004 and 2015. The rate of PICU admission for opioid-related hospitalization increased significantly, from 24.9 to 35.9 per 10 000 PICU admissions (P < .001). Among PICU admissions, 37.0% required mechanical ventilator support, and 20.3% required vasopressors.

CONCLUSIONS: The US opioid crisis is negatively impacting children, and the rate of hospitalization and PICU admission for pediatric opioid ingestions is increasing. Current efforts to reduce adult opioid use have not curtailed the incidence of pediatric opioid ingestions, and additional efforts are needed to reduce preventable opioid exposure in children.



http://pediatrics.aappublications.org/content/early/2018/03/01/peds.2017-3335



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Ed Gottlieb
Chair, Coalition for Safe Medication Disposal
Board Member, New York Product Stewardship Council
Member, National Association of Clean Water Agencies Pretreatment & Pollution Prevention Committee
Member, Product Stewardship Institute Pharmaceuticals’ Policy & Coordination Work Group
Member, New York Water Environment Association Government Affairs Committee
Member, Tompkins County Water Resources Council
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381<tel:(607)%20273-8381>
fax: (607) 273-8433<tel:(607)%20273-8433>

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