126 Persistent opioid use after pediatric fracture treatment

Background and Aims The opioid epidemic persists as one of the most critical public health concerns in the United States. In the pediatric population, fractures are among the primary causes for surgical interventions. Therefore, the identification of opioid prescription patterns and potential risk factors for prolonged opioid use is critical.1 We hypothesized that the numbers of pediatric patients with persistent opioid use after surgery would be significant and that several risk factors driving persistent opioid use could be identified. Methods A retrospective population-based cohort study was conducted. National claims data from the Truven Health MarketScan database were utilized to 1) characterize opioid prescription patterns, and 2) describe the epidemiology and risk factors for single use as well as persistent use of opioids among pediatric patients with surgical fracture treatment. Results Among 303,335 patients, 21.54% received at least 1 opioid prescription within 6 months after surgery, and 1,671 (0.6%) developed persistent opioid use. Risk factors for persistent opioid use included older age, female gender, lower extremity trauma, surgeries of the spine, rib cage or head, closed fracture treatment, earlier surgery years, previous use of opioid, and higher comorbidity burden. Conclusions Among a cohort of pediatric patients who underwent surgical fracture treatment, 21.5% filled at least 1 opioid prescription, and 0.6% (n=1,671) filled at least one more opioid prescription between 3 to 6 months after surgery. Understanding the risk factors associated with persistent opioid use in pediatric patients is critical for the development of prevention strategies in this patient population.