PD14-01 INCREASED RISK OF NEW PERSISTENT OPIOID USE IN PEDIATRIC AND YOUNG ADULT UROLITHIASIS PATIENTS PRESCRIBED OPIOIDS AT PRESENTATION
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Résumé
You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (PD14)1 Apr 2020PD14-01 INCREASED RISK OF NEW PERSISTENT OPIOID USE IN PEDIATRIC AND YOUNG ADULT UROLITHIASIS PATIENTS PRESCRIBED OPIOIDS AT PRESENTATION Gregory Hosier*, Thomas McGregor, Darren Beiko, Michael Di Lena, Christopher Booth, Marlo Whitehead, and D. Robert Siemens Gregory Hosier*Gregory Hosier* More articles by this author , Thomas McGregorThomas McGregor More articles by this author , Darren BeikoDarren Beiko More articles by this author , Michael Di LenaMichael Di Lena More articles by this author , Christopher BoothChristopher Booth More articles by this author , Marlo WhiteheadMarlo Whitehead More articles by this author , and D. Robert SiemensD. Robert Siemens More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000848.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pediatric and young adults are a vulnerable patient population for development of addiction after opioid exposure. The incidence of pediatric urolithiasis has been steadily increasing for the past several decades. However, the long-term impact of opioid prescribing in pediatric and young adult patients with urolithiasis is not known. Our objective was to describe rates of opioid prescription and identify risk factors for persistent opioid use in patients <25 years old with urolithiasis. METHODS: Using previously validated linked administrative databases we performed a population-based retrospective study of all opioid-naïve patients <25 years old with a diagnosis of urolithiasis between July 1, 2013 and September 30, 2017 in Ontario, Canada. All family practitioner, Emergency department, and specialist visits in the province were captured. Our primary outcome was persistent opioid use defined as filling a prescription for an opioid between 91 and 180 days after initial urolithiasis visit. Secondary outcomes were opioid addiction and opioid overdose. Ontario utilizes a narcotic monitoring system, which captures all opioids dispensed in the province. RESULTS: Of the 6962 patients identified, 56% were prescribed an opioid at presentation and 34% of those were dispensed more than 200 oral morphine equivalents (OME). There was persistent opioid use in 313 (8.1%) patients who filled an initial opioid prescription. Those prescribed an opioid initially had a significantly higher risk of persistent opioid use (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.5–2.3), opioid addiction (OR 3.6, 95% CI 1.2-10.6), and opioid overdose (OR 2.8, 95% CI 0.9-8.5) compared to those without initial opioid exposure. In adjusted analysis, initial exposure of >300 OME (OR 2.2, 95% CI 1.5-3.3), history of mental illness (OR 1.3, 95% CI 1.0-1.7), and need for surgery (OR 1.7, 95% CI 1.2-2.3) were all risk factors for persistent opioid use (Table 1). CONCLUSIONS: Among urolithiasis patients <25 years old, filling an opioid prescription after presentation is associated with an increased risk of persistent opioid use 3-6 months later and a higher risk of serious long-term complications such as opioid addiction and overdose. Source of Funding: This work was funded by the PSI foundation. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e272-e272 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory Hosier* More articles by this author Thomas McGregor More articles by this author Darren Beiko More articles by this author Michael Di Lena More articles by this author Christopher Booth More articles by this author Marlo Whitehead More articles by this author D. Robert Siemens More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».