TY - JOUR
T1 - The Association Between Opioid Use and Outcomes in Infants Undergoing Pyloromyotomy
AU - McLaughlin, Cory
AU - Squillaro, Anthony I.
AU - Ourshaliman, Shadassa
AU - Song, Ashley
AU - Lakshmanan, Ashwini
AU - Cucchiaro, Giovanni
AU - Hall, Matthew
AU - Burke, Rita V.
AU - Kelley-Quon, Lorraine I.
N1 - Funding Information:
Dr. Kelley-Quon and Dr. Lakshmanan are supported by grant KL2TR001854 from the National Center for Advancing Translational Sciences (NCATS) of the U.S. National Institutes of Health . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2019
PY - 2019/9
Y1 - 2019/9
N2 - Purpose: The purpose of this study was to describe the frequency and variation of opioid use across hospitals in infants undergoing pyloromyotomy and to determine the impact of opioid use on postoperative outcomes. Methods: A retrospective cohort study (2005–2015) was conducted by using the Pediatric Health Information System (PHIS) database, including infants (aged <6 months) with pyloric stenosis who underwent pyloromyotomy. Infants with significant comorbidities were excluded. Opioid use was classified as a patient receiving at least 1 opioid medication during his or her hospital stay and categorized as preoperative, day of surgery, or postoperative (≥1 day after surgery). Outcomes included prolonged hospital length of stay (LOS; ≥3 days) and readmission within 30 days. Findings: Overall, 25,724 infants who underwent pyloromyotomy were analyzed. Opioids were administered to 6865 (26.7%) infants, with 1385 (5.4%) receiving opioids postoperatively. In 2015, there was significant variation in frequency of opioid use by hospital, with 0%–81% of infants within an individual hospital receiving opioids (P < 0.001). Infants only receiving opioids on the day of surgery exhibited decreased odds of prolonged hospital LOS (odds ratio [OR], 0.85; 95% CI, 0.78–0.92). Infants who received an opioid on both the day of surgery and postoperatively exhibited increased odds of a prolonged hospital LOS (OR, 1.71; 95% CI, 1.33–2.20). Thirty-day readmission was not associated with opioid use (OR, 1.03; 95% CI, 0.93–1.14). Implications: There is national variability in opioid use for infants undergoing pyloromyotomy, and postoperative opioid use is associated with prolonged hospital stay. Nonopioid analgesic protocols may warrant future investigation.
AB - Purpose: The purpose of this study was to describe the frequency and variation of opioid use across hospitals in infants undergoing pyloromyotomy and to determine the impact of opioid use on postoperative outcomes. Methods: A retrospective cohort study (2005–2015) was conducted by using the Pediatric Health Information System (PHIS) database, including infants (aged <6 months) with pyloric stenosis who underwent pyloromyotomy. Infants with significant comorbidities were excluded. Opioid use was classified as a patient receiving at least 1 opioid medication during his or her hospital stay and categorized as preoperative, day of surgery, or postoperative (≥1 day after surgery). Outcomes included prolonged hospital length of stay (LOS; ≥3 days) and readmission within 30 days. Findings: Overall, 25,724 infants who underwent pyloromyotomy were analyzed. Opioids were administered to 6865 (26.7%) infants, with 1385 (5.4%) receiving opioids postoperatively. In 2015, there was significant variation in frequency of opioid use by hospital, with 0%–81% of infants within an individual hospital receiving opioids (P < 0.001). Infants only receiving opioids on the day of surgery exhibited decreased odds of prolonged hospital LOS (odds ratio [OR], 0.85; 95% CI, 0.78–0.92). Infants who received an opioid on both the day of surgery and postoperatively exhibited increased odds of a prolonged hospital LOS (OR, 1.71; 95% CI, 1.33–2.20). Thirty-day readmission was not associated with opioid use (OR, 1.03; 95% CI, 0.93–1.14). Implications: There is national variability in opioid use for infants undergoing pyloromyotomy, and postoperative opioid use is associated with prolonged hospital stay. Nonopioid analgesic protocols may warrant future investigation.
KW - infant
KW - opioid
KW - pyloric stenosis
KW - pyloromyotomy
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U2 - 10.1016/j.clinthera.2019.07.002
DO - 10.1016/j.clinthera.2019.07.002
M3 - Article
C2 - 31409555
AN - SCOPUS:85070329817
SN - 0149-2918
VL - 41
SP - 1690
EP - 1700
JO - Clinical therapeutics
JF - Clinical therapeutics
IS - 9
ER -