Evaluating Patient-Specific Characteristics Predisposing Pediatric Plastic Surgery Patients to Opioid Prescription at Discharge

ObjectivePrevious research indicates a rise in adult opioid misuse due to childhood opioid use. This study seeks to identify patient-specific features associated with postoperative opioid prescriptions at discharge in pediatric plastic surgery patients.DesignSingle-institution, retrospective review.SettingLevel 1 Pediatric Surgery Center.Patients, ParticipantsPatients under 18 years old who underwent surgery by a single pediatric plastic surgeon between January 2020 and November 2022 (N = 429).InterventionSurgery by a plastic surgeon.Main Outcome MeasurePresence of an active opioid prescription at hospital discharge.ResultsIn total, 429 patients were analyzed. Upon multivariate analysis, opioid use in inpatient setting (aOR: 4.310; 95% CI: 1.035-17.960; <i>P</i> = .045), private insurance (aOR: 2.031; 95% CI: 1.071-3.854; <i>P</i> = .030), prior surgical history (aOR: 2.015; 95% CI: 1.089-3.726; <i>P</i> = .026), increased age (aOR: 1.164; 95% CI: 1.101-1.230; <i>P</i> < .001), and increased operative time (aOR: 1.016; 95% CI: 1.012-1.020; <i>P</i> < .001) independently increased the odds of having an opioid prescription at discharge. Patients that underwent cleft palate procedures (aOR: 2.299; 95% CI: 1.124-4.702; <i>P</i> = .023) or breast procedures (aOR: 6.768; 95% CI: 1.293-35.425; <i>P</i> = .024) had increased odds of an opioid prescription at discharge. Patients undergoing cutaneous procedures experienced decreased odds of an opioid prescription at discharge (aOR: 0.206; 95% CI: 0.081-0.528; <i>P</i> = .001).ConclusionsPatient-specific features, including demographic and clinical characteristics, were identified as independent predictors of opioid prescription at discharge in this pediatric plastic surgery patient population.