Incidence and Predictors of Opioid Prescription at Discharge After Traumatic Injury

摘要: Importance In the current health care environment with increased scrutiny and growing concern regarding opioid use abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent population that may be affected by this regulation, as incidence pain at hospital discharge is than 95%, opioids are considered first line treatment for management. However, in trauma not explored. Objective To study predictors prescription large national cohort. Design, Setting, Participants Analysis adult (18-64 years), opioid-naive who were beneficiaries Military Health Insurance (military personnel their dependents) treated both military facilities civilian centers hospitals between January 1, 2006, December 31, 2013, was conducted. Patients burns, foreign body injury, toxic effects, or late complications excluded. Prior diagnosis within 1 year in-hospital death also grounds exclusion. Injury mechanism severity, comorbid conditions, mental disorders, demographic factors covariates. The Drug Enforcement Administration’s list scheduled narcotics used to query use. Unadjusted adjusted logistic regression models determine prescription. Data analysis performed from June 7 August 21, 2016. Exposures factors. Main Outcomes Measures Prescription analgesics discharge. Results Among 33 762 included (26 997 [80.0%] men; mean [SD] age, 32.9 [13.3] 18 338 (54.3%) received an risk-adjusted models, older age (45-64 vs 18-24 years: odds ratio [OR], 1.28; 95% CI, 1.13-1.44), marriage (OR, 1.26; 1.20-1.34), higher Severity Score (≥9 Conclusions Relevance closely matches moderate severe patients, indicating appropriate prescribing practices. We advocate injury severity level pain—not arbitrary regulations—should inform decision prescribe