The Impact of Opioids on Health Outcomes for Hospitalized Infants

阿片类药物对住院婴儿健康结果的影响

• 批准号: 10570951
• 负责人: Lorraine I Kelley-Quon
• 金额: $ 62.24万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570951
• 关键词: Acute; Address; Admission activity; Birth Weight; Brain Death; Brain Injuries; California; Caring; Cessation of life; Child; Childhood; Clinical; Clinical Data; Clinical Protocols; Cognitive; Cost Analysis; Critical Illness; Data; Data Set; Databases; Dedications; Dependence; Development; Developmental Disabilities; Dose; Exposure to; Extracorporeal Membrane Oxygenation; Fentanyl; Goals; Health; Health Information System; Health Policy; Helping to End Addiction Long-term; Hormonal; Hospitalization; Hospitals; Hydromorphone; Infant; Institution; Intervention; Language; Length of Stay; Link; Longterm Follow-up; Methadone; Morbidity - disease rate; Morphine; Motor; Necrotizing Enterocolitis; Neonatal; Neonatal Abstinence Syndrome; Neurocognitive; Neurodevelopmental Disability; Neurologic; Operative Surgical Procedures; Opioid; Outcome; Pain; Pain management; Parenteral Nutrition; Pediatric Hospitals; Perinatal; Pharmaceutical Preparations; Pharmacy facility; Physiological; Policy Maker; Population; Population Heterogeneity; Pregnancy; Procedures; Public Health; Quality of Care; Regression Analysis; Research; Resources; Risk; Shapes; Survivors; Time; United States; United States National Institutes of Health; Variant; Ventilator; Weight; cardiovascular risk factor; cohort; comorbidity; congenital heart disorder; cost; cost comparison; disability; early childhood; experience; health care service utilization; health difference; high risk infant; impaired brain development; improved; infancy; instrument; longitudinal dataset; morphine equivalent; neonatal care; neurodevelopment; novel; opioid abuse; opioid exposure; opioid use; prenatal; prescription opioid; prevent; programs; response

PROJECT SUMMARY Caring for hospitalized infants requires a comprehensive pain control program aimed at reducing and preventing pain. While opioids are commonly used when an infant undergoes a painful procedure, opioids can increase the risk of short- and long-term morbidity. The duration and type of opioids used for hospitalized infants varies widely between institutions and such wide variations could impact early childhood development and overall healthcare utilization. In this study, we will create a novel clinical and developmental dataset by merging the Pediatric Health Information System (PHIS) and the California Perinatal Quality Care Collaborative (CPQCC). This merged dataset will be the first large retrospective, multi-center cohort representing diverse populations of critically ill, hospitalized infants linking their in-hospital data with long-term neurodevelopmental outcomes. Using this novel dataset, we will (1) identify variations in opioid use associated with neurodevelopmental disability and long-term resource utilization for high-risk infants, (2) quantify cumulative opioid dosing received associated with neurodevelopmental disability for high-risk infants, and (3) quantify differences in healthcare utilization and costs associated with high vs. low opioid use among high-risk infants. The expected outcome is a comprehensive understanding of the variations in opioid use for high-risk infants and its impact on neurodevelopment and healthcare utilization. Results will lead to interventions for hospitalized infants aimed at minimizing variation in pain control and will also inform policymakers of a previously unrecognized infant population in need of increased resources to improve clinical and developmental outcomes.

项目总结 照顾住院婴儿需要一个全面的疼痛控制计划，旨在减少和预防 疼痛。虽然阿片类药物通常在婴儿经历痛苦的程序时使用，但阿片类药物可以增加 有短期和长期发病的风险。住院婴儿使用阿片类药物的时间和类型差异很大。 机构之间的差异如此之大，可能会影响儿童早期发展和整体医疗保健 利用率。在这项研究中，我们将通过合并儿科健康创建一个新的临床和发育数据集 信息系统(PHIS)和加州围产期质量护理协作(CPQCC)。这次合并 数据集将是第一个代表不同危重人群的大型多中心回顾队列， 住院婴儿将他们的住院数据与长期神经发育结果联系起来。用这本小说 数据集，我们将(1)确定与神经发育障碍和长期使用阿片类药物相关的变化 高危婴儿的资源利用，(2)量化与以下相关的累积阿片类药物剂量 高危婴儿的神经发育障碍，以及(3)量化医疗利用和费用的差异 与高危婴儿中高阿片类药物使用与低阿片类药物使用有关。预期结果是全面的 了解高危婴儿阿片类药物使用的变化及其对神经发育和 医疗保健利用率。结果将导致针对住院婴儿的干预措施，旨在最大限度地减少 疼痛控制，并将告知政策制定者以前未被认识到的婴儿人口需要增加 用于改善临床和发育结果的资源。