Evidence map›Paper›PMID 39241291›Full record

ArticleThe Journal of surgical research2024

The Cost of Opioid Use in High-Risk Hospitalized Infants.

Olivia A Keane, Shadassa Ourshalimian, Cameron Kaplan, Cynthia Gong, Ashwini Lakshmanan, Susan Hintz, Henry C Lee, Madeleine Ing, Rabab Barq, Nam Nguyen and 1 more

Abstract read
In one paragraph

Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Olivia A KeaneDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California. Electronic address: okeane@emory.edu.
Shadassa OurshalimianDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
Cameron KaplanUSC Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, Los Angeles, California.
Cynthia GongDivision of Neonatology, Department of Pediatrics, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California.
Ashwini LakshmananDepartment of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine, Pasadena, California.
Susan HintzDivision of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
Henry C LeeDivision of Neonatology, University of California San Diego, La Jolla, California.
Madeleine IngDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California.
Rabab BarqDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
Nam NguyenDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California; Division of Pediatric Surgery, Memorial Care Miller Children's & Women's Hospital, Long Beach, California.
Lorraine I Kelley-QuonDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Funding

The Impact of Opioids on Health Outcomes for Hospitalized InfantsR01HD105656 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI Lorraine I Kelley-Quon · 2022 to 2026
$3.1M
NICHD NIH HHS R01 HD105656
6 · The paper itself

Abstract

introductionHospitalizations of high-risk infants are among the most expensive in the United States, with many requiring surgery and months of intensive care. Healthcare costs and resource use associated with hospitalized infant opioid exposure are less well known.

methodsA retrospective cohort of high-risk infants aged <1 y admitted from 47 children's hospitals from 2010 to 2020 was identified from Pediatric Healthcare Information System. High-risk infants were identified by International Classification of Diseases 9/10 codes for congenital heart disease procedures, medical and surgical necrotizing enterocolitis, extremely low birth weight, very low birth weight, hypoxemic ischemic encephalopathy, extracorporeal membrane oxygenation, and gastrointestinal tract malformations. Healthcare resource utilization was estimated using standardized unit costs (SUCs). The impact of opioid use on SUC was examined using general linear models and an instrumental variable.

resultsOverall, 126,897 high-risk infants were identified. The cohort was majority White (57.1%), non-Hispanic (72.0%), and male (55.4%). Prematurity occurred in 26.4% and a majority underwent surgery (77.9%). Median SUC was $120,585 (interquartile range: $57,602-$276,562) per infant. On instrumental variable analysis, each day of opioid use was associated with an increase of $4406 in SUC. When adjusting for biologic sex, race, ethnicity, insurance type, diagnosis category, number of comorbidities, mechanical ventilation, and total parental nutrition use, each day of opioid use was associated with an increase of $2177 per infant.

conclusionsProlonged opioid use is significantly associated with healthcare utilization and costs for high-risk infants, even when accounting for comorbidities, intensive care, ventilation, and total parental nutrition use. Future studies are needed to estimate the long-term complications and additional costs resulting from prolonged opioid exposures in high-risk infants.

Indexed as

Analgesics, OpioidFemaleHealth Care CostsHospital CostsHospitalizationHumansInfantInfant, NewbornMaleRetrospective StudiesUnited StatesAnalgesics, OpioidHealthcare costHigh-risk infantsHospitalized infantsOpioid costsOpioid useResource utilization

Identifiers

PMID39241291
PMCPMC11552099

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.