Page 3 - CUA 2020_Endourology

Podium 1: Endourology, Nephrolithiasis

POD-1.3
Increased risk of new persistent opioid use in pediatric and young
adult urolithiasis patients prescribed opioids at presentation
2
1
Gregory Hosier , Thomas McGregor , Darren T. Beiko , Gregory E. Tasian ,
1
1
1
Michael A. Di Lena , Christopher M. Booth , Marlo Whitehead , D. Robert
1
3
Siemens 1
1 Urology, Queen’s University, Kingston, ON, Canada; Pediatric
2
Urology, Children’s Hospital of Philadelphia, Philadelphia, PA, United
States; Medical Oncology, Queen’s University, Kingston, ON, Canada
3
Support: PSI Foundation
Introduction: The incidence of pediatric urolithiasis has been steadily
increasing for the past several decades. Pediatric and young adults are a
vulnerable patient population for development of addiction after opioid
exposure. However, the long-term impact of opioid prescribing in pediat-
POD-1.2. Fig. 1. Number of PUL surgical stone procedures performed in ric and young adult patients with urolithiasis is not known. Our objective
Ontario (2002–2016). was to describe rates of opioid prescription and identify risk factors for
persistent opioid use in patients age 25 years or younger with urolithiasis.
POD-1.3. Table 1. Factors associated with persistent opioid use among urolithiasis patients <25 years old initially
prescribed opioids in Ontario from 2013–2017 (N=3877)
Characteristic Rate Univariate analysis p Multivariable analysis p
OR (95%CI) OR (95%CI)
Patient-related
Age, years
0–11 2 0.21 (0.03–1.51) 0.18 0.16 (0.02–1.22) 0.22
12–18 9 1.24 (0.87–1.75) 1.20 (0.83–1.70)
19–21 7 Ref Ref
22–25 9 1.20 (0.91–1.6) 1.06 (0.8–1.4)
Sex
Female 9 1.22 (0.97–1.5) 0.09 1.15 (0.90–1.48) 0.26
Male 7 Ref Ref
Mental health history
No 7 Ref 0.0025 Ref 0.0338
Yes 10 1.43 (1.13–1.80) 1.32 (1.02–1.71)
Care-related
Duration urolithiasis episode
<60 days 6 0.45 (0.35–0.57) <0.0001 0.62 (0.47–0.82) 0.0008
>60 days 13 Ref Ref
# ED visits for urolithiasis after index
visit
0 6 0.24 (0.17– 0.35) <0.0001 0.49 (0.32–0.74) 0.0059
1 8 0.32 (0.21–0.47) 0.5 (0.33–0.79)
2 13 0.57 (0.36–0.90) 0.68 (0.42–1.09)
>2 21 Ref Ref
Had surgery
No 7 Ref <0.0001 Ref 0.0009
Yes 14 2.30 (1.77–2.99) 1.7 (1.24–2.34)
Opioid-related
Total oral morphine equivalents
during acute stone episode
1–99 5 Ref <0.0001 Ref <0.0001
100–149 6 1.07 (0.71–1.62) 1.0 (0.65–1.52)
150–199 7 1.29 (0.85–1.95) 1.18 (0.77–1.80)
200–299 8 1.62 (1.09–2.42) 1.35 (0.90–2.04)
>300 17 3.79 (2.64–5.44) 2.21 (1.49–3.29)

CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S25