Monika K. Goyal, Amy L. Drendel, James M Chamberlain, Justin Wheeler, Cody Olsen, Robert W. Grundmeier, Larry Cook, Lalit Bajaj, Lynn Babcock, Joeseph J. Zorc, Tiffani Johnson, Elizabeth R. Alpern, Pediatric Emergency Care Applied Research Network (PECARN) Registry Study Group, Pediatric Emergency Care Applied Research Network (PECARN) Registry Study Group

Oct 13, 2021

Abbreviations:aOR — adjusted odds ratioCI — confidence intervalED — emergency departmentRR — relative reductionPain caused by long bone fractures is a common reason for opioid prescribing in the emergency department (ED) Setting Approximately 40% of opioid overdose deaths involve a prescription,2 and in response, opioid prescribing has declined in the last decade.3 We previously demonstrated racial and/or ethnic disparities in the ED management of pain among children with long bone fractures.4 We now perform this study to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have attenuated over time.
Method We performed a retrospective cross-sectional study of children aged 4 to <18 years with long bone fractures (clavicle, humerus, ulna, radius, femur, tibia, and fibula, as identified by International Classification of Diseases, Ninth Revision, Clinical Modification, and International Classification of Diseases, 10th Revision, Clinical Modification, diagnosis codes or natural-language processing of radiology reports5) using the Pediatric Emergency Care Applied Research Network Registry, an electronic health record registry of 4 geographically diverse (northeast, south, west, and midwest) pediatric EDs from January 1, 2012, to December 31, 2019.6 We included patients with an Emergency Severity Index of 2 to 4, at least 1 pain score, and disposition of ED discharge. Race and/or ethnicity were categorized as non-Hispanic White, non-Hispanic Black, Hispanic, and … Address correspondence to Monika Goyal, MD, MSCE, Division of Emergency Medicine, Children’s National Hospital, 111 Michigan Ave, NW, Washington, DC 20010. ...

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