Cohen et al reported a number of factors associated with severe outcomes in pediatric patients abusing opioids. The authors are from the ToxIC Pediatric Opioid Exposure Study Group and multiple institutions in Canada and the United States.
Patient selection: pediatric patient exposed to opioids
Outcome: ICU admission, in-hospital mortality
Almost half of the children were exposed to opioids prescribed for family members. Since pediatric patients typically weigh less than an adult, an adult dose has a greater effect in a pediatric patient.
Risk factors for poor outcome:
(1) age >= 10 years (OR 2.5)
(2) exposure to fentanyl (OR 3.6)
This pattern of findings indicates intentional exposure.
Other factors that may impact outcomes:
(1) mixed intoxications (with alcohol, with benzodiazepines, etc)
(2) availability of naloxone at the scene
(3) delay in medical care
