Pediatric ICU Admissions for Opioid Ingestion Continue to Rise

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Pediatric intensive care unit admissions related to opioid ingestions were found to double from 2004 to 2015.
Pediatric intensive care unit admissions related to opioid ingestions were found to double from 2004 to 2015.

Pediatric intensive care unit (ICU) admissions related to opioid ingestion were found to double from 2004 to 2015 in a study published in Pediatrics.

In this retrospective analysis of the Pediatric Health Information System (PHIS) database, investigators obtained data on pediatric hospitalizations for opioid exposure in the United States between 2004 and 2015 (n=3647). Of the hospitalizations included in the analysis, 42.9% required care in the pediatric ICU.

The investigators used billing data for these patients to evaluate participants' use of naloxone, vasopressors, and ventilation. The trend in the rate of pediatric ICU admissions for opioid exposure over time was the primary outcome.

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Opioid-related hospitalizations increased from 6.7 per 10,000 admissions in 2004 to 10.9 per 10,000 admissions in 2015 (P <.001). Pediatric ICU admissions related to opioid ingestion rose from 24.9 per 10,000 in 2004 to 36.6 per 10,000 admissions in 2015 (P <.001).

During this period, the overall mortality was 1.6%, with annual death rates decreasing from 2.8% in the 2004 to 2007 period to 1.3% in the 2012 to 2015 period (P <.001). There was also a significant decrease in mortality over time in the 1- to 5-year-old age group (P <.001).

In addition, more patients were discharged to other care facilities, with significant decreases observed in the number of patients discharged home following hospital admission (P <.001).

The investigators note that these findings observed in the PHIS database may not be generalizable to patients receiving care in nontertiary centers and non-children's hospitals. In addition, the PHIS database includes only approximately 20% of data on pediatric hospitalizations, which may understate the exact care and/or cost effects across the entire population.

“Current efforts to reduce prescription opioid use in adults have not curtailed the incidence of pediatric opioid ingestion, and additional efforts are needed to reduce preventable opioid exposure in children,” concluded the investigators.

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Reference

Kane JM, Colvin JD, Bartlett AH, Hall M. Opioid-related critical care resource use in US children's hospitals. Pediatrics. 2018;141(4): e20173335.

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