Ferrantella Anthony, Huerta Carlos T, Quinn Kirby, Mavarez Ana C, Quiroz Hallie J, Thorson Chad M, Perez Eduardo A, Sola Juan E
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.
University of Miami Miller School of Medicine, Miami, FL, USA.
Pediatr Surg Int. 2022 Jun;38(6):843-851. doi: 10.1007/s00383-022-05088-0. Epub 2022 Mar 3.
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.
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.
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%).
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.
识别高危儿童可为采取预防措施避免阿片类药物成瘾提供关键契机。本研究旨在确定在因阿片类药物相关入院之前曾因其他原因住院的高危儿科患者。
对全国再入院数据库（2010 - 2014年）进行查询，以获取1至18岁因阿片类药物相关住院的儿童信息。比较此前的入院情况（最多提前1年）及相关诊断。对结果进行加权以得出全国估计数。
共识别出51,349例与阿片类药物相关的住院病例，总体住院死亡率为0.8%。17%的患者在同一年度有过此前的入院记录，其中44%有超过1次此前入院记录，11%有≥5次此前入院记录。仅有4%的此前入院发生在不同医院。男性和女性比例相当，82%的患者年龄≥13岁。仅有16%的此前入院患者在之前的住院期间接受过大型外科手术。此前住院患者最常见的合并诊断为药物滥用（37%）、慢性肺病（18%）和抑郁症（10%）。
与阿片类药物相关的住院情况常发生在近期多次入院的儿童中，且通常是在同一家医院。大多数患者没有癌症病史或近期手术史来解释其阿片类药物使用情况。
