The Impact of Opioids on Health Outcomes for Hospitalized Infants

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Principal Investigator: Lorraine I Kelley-Quon
Organization: CHILDREN'S HOSPITAL OF LOS ANGELES
Fiscal Year: 2024
Award: $605,870
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development

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.

Terms: <0-11 years old><Acquired brain injury><Actiq><Acute><Adanon><Address><Admission><Admission activity><Althose><Birth Weight><Brain Dead><Brain Death><Brain Injuries><California><Cardiac Malformation><Caring><Cessation of life><Child><Child Development Disorders><Child Youth><Childhood><Children (0-21)><Children's Hospital><Clinical><Clinical Data><Clinical Protocols><Cognitive><Coma Depasse><Cost Analyses><Cost Analysis><Critical Illness><Critically Ill><Data><Data Bases><Data Set><Databases><Death><Dedications><Dependence><Development><Developmental Disabilities><Dihydromorphinone><Dilaudid><Dilaudid HP><Dimorphone><Dolophine><Dose><Drugs><Duragesic><Exposure to><Extracorporeal Membrane Oxygenation><Fentanest><Fentanyl><Fentyl><Gestation><Goals><HEAL Initiative><Health><Health Care Utilization><Health Information System><Health Policy><Heart Malformation><Helping End Addiction Long-term><Helping End Addiction Longterm><Helping to End Addiction Long-term><Helping to End Addiction Longterm><Hormonal><Hospital Admission><Hospitalization><Hospitals><Hydromorphon><Hydromorphone><Hydrostat><Hymorphan><Infant><Infumorph><Institution><Intervention><Intervention Strategies><Intravenous Feeding><Intravenous Hyperalimentation><Kadian><Language><Laudacon><Laudicon><Length of Stay><Link><Long-term Follow-up><Longterm Follow-up><MS Contin><MSir><Medication><Methadone><Methadose><Morbidity><Morbidity - disease rate><Morphia><Morphine><Motor disability><NIH><National Institutes of Health><Necrotizing Enterocolitis><Neonatal><Neonatal Abstinence Syndrome><Neonatal Opioid Withdrawal Syndrome><Neonatal Substance Withdrawal><Neonatal Withdrawal Syndrome><Neural Development><Neurocognitive><Neurodevelopmental Disability><Neurologic><Neurological><Novolauden><Number of Days in Hospital><Operative Procedures><Operative Surgical Procedures><Opiates><Opioid><Oramorph><Oramorph SR><Outcome><Pain><Pain Control><Pain Therapy><Pain management><Painful><Parenteral Feedings><Parenteral Nutrition><Pediatric Hospitals><Perinatal><Peripartum><Pharmaceutical Preparations><Pharmacies><Pharmacy facility><Phentanyl><Physiologic><Physiological><Policy Maker><Population><Population Heterogeneity><Pregnancy><Procedures><Public Health><QOC><Quality of Care><Regression Analyses><Regression Analysis><Regression Diagnostics><Research><Research Resources><Resources><Risk><Roxanol><Shapes><Statex SR><Statistical Regression><Surgical><Surgical Interventions><Surgical Procedure><Survivors><Time><United States><United States National Institutes of Health><Variant><Variation><Ventilator><Weight><abnormal heart development><assess cost><brain damage><brain-injured><cardiovascular risk><cardiovascular risk factor><cerebral death><co-morbid><co-morbidity><cohort><comorbidity><compare cost><congenital cardiac abnormality><congenital cardiac anomalies><congenital cardiac disease><congenital cardiac disorder><congenital cardiac malformation><congenital heart abnormality><congenital heart anomaly><congenital heart disease><congenital heart disorder><congenital heart malformation><cost><cost assessment><cost comparison><cost evaluation><data base><developmental><differences in health><disability><diverse populations><drug/agent><early childhood><evaluate cost><examine cost><experience><health care policy><health care service use><health care service utilization><health difference><healthcare policy><healthcare service use><healthcare service utilization><healthcare utilization><heterogeneous population><high risk infant><hospital days><hospital length of stay><hospital stay><hyperalimentation><hyperalimentation therapy><impaired brain development><improved><infancy><infantile><instrument><interventional strategy><kids><licit opioid><long-term followup><longitudinal data set><longitudinal dataset><longterm followup><morphine equivalence><morphine equivalent><neonatal care><neurodevelopment><newborn abstinence syndrome><novel><opiate abuse><opiate consumption><opiate drug abuse><opiate drug use><opiate exposure><opiate intake><opiate medication><opiate use><opioid abuse><opioid consumption><opioid drug abuse><opioid drug use><opioid exposure><opioid intake><opioid medication><opioid use><pain treatment><pediatric><population diversity><prenatal><prescribed opiate><prescribed opioid><prescription opiate><prescription opioid><prevent><preventing><programs><response><surgery><unborn><vulnerable infant><weights><youngster>