ArticleJournal of the American College of Surgeons2022
Multi-Institutional Quality Improvement Project to Minimize Opioid Prescribing in Children after Appendectomy Using NSQIP-Pediatric.
Article in Journal of the American College of Surgeons, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 24 citations in OpenAlex.
- Rethinking postoperative opioid use in pediatric appendectomy: a cross-cultural comparison between Japan and North America.Journal of anesthesia · 2026Article
- Comparing Provider and Adolescent Estimates of Postoperative Opioid Use.The Journal of surgical research · 2025Article
- Evaluating Postoperative Opioid Prescription Fills and Refills for Adolescents Undergoing Surgery.Journal of pediatric surgery · 2025Article
- Institutional and Regional Variation in Opioid Prescribing for Hospitalized Infants in the US.JAMA network open · 2024Article
- A Quality Improvement Initiative to Reduce Opioid Prescriptions Following Surgical Treatment of Supracondylar Humerus Fractures in Children.Journal of the Pediatric Orthopaedic Society of North America · 2023Article
- Annual Prevalence of Opioid Receipt by South Carolina Medicaid-Enrolled Children and Adolescents: 2000-2020.International journal of environmental research and public health · 2023Article
- Opioid stewardship program implementation in pediatric surgeries: A systematic review.Saudi journal of anaesthesiaReview
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Authors and funding
19 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundThere is wide variation in opioid prescribing after appendectomy in children and adolescents, with recent increases noted in opioid-related pediatric deaths from prescription and illicit opioids. The goal of this project was to minimize opioid prescribing at the time of discharge for children undergoing appendectomy by using Quality Improvement (QI) methodology. STUDY
designChildren (18 years of age or less) who underwent appendectomy were evaluated from January to December 2019 using NSQIP-Pediatric at 10 children's hospitals within the Western Pediatric Surgery Research Consortium. Before project initiation, 5 hospitals did not routinely prescribe opioids after appendectomy (protocol). At the remaining 5 hospitals, prescribing was not standardized and varied by surgeon (no-protocol). A prospective multi-institutional QI project was used to minimize outpatient opioid prescriptions for children after appendectomy. The proportion of children at each hospital receiving an opioid prescription at discharge was compared for 6 months before and after the intervention using chi-square analysis.
resultsOverall, 1,524 children who underwent appendectomy were evaluated from January to December 2019. After the QI intervention, overall opioid prescribing decreased from 18.2% to 4.0% (p < 0.001), with significant decreases in protocol hospitals (2.7% vs 0.8%, p = 0.038) and no-protocol hospitals (37.9% vs 8.8%, p < 0.001). The proportion of 30-day emergency room visits did not change after the QI intervention (8.9% vs 9.9%, p = 0.54) and mean postintervention pain management satisfaction scores were high.
conclusionOpioid prescribing can be minimized in children after appendectomy without increasing emergency room visits or decreasing patient satisfaction. Furthermore, NSQIP-Pediatric can be used as a platform for multi-institutional collaboration for successful implementation of QI projects.
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