LEP was not associated with proportion given opioids at 24h after surgery (31% vs 32%)

Description #

Over the full 24-hour postoperative period, LEP status was not associated with the proportion of patients administered opioids on the floor (31% vs 32%, P = .80) (Table 3). This is a null finding. Together with the null 24-hour opioid dose and nonopioid results, it supports the authors' interpretation that the 12-hour analgesia disparity narrowed by 24 hours.

"...at 24 hours LEP was not associated with the proportion of patients administered opioids (31% vs 32%, P = .80)..." (Plancarte, 2021, p. 1201)

Methods Context #

What? #ⓘ

The observable: the proportion of patients administered floor opioids within the 24-hour postoperative period.

"Floor opioids given (%)" (Plancarte, 2021, p. 1203, Table 3)

How? #ⓘ

Bivariate comparison of the proportion between LEP and EP families using χ²/Fisher's exact tests on retrospective chart-abstracted data.

"Bivariate association tests comparing the demographic, clinical characteristics, and secondary outcomes between pediatric patients in English proficient and LEP families were performed by using t tests, Mann-Whitney, v2, or Fisher's exact tests as appropriate." (Plancarte, 2021, p. 1201)

Who? #ⓘ

306 children aged 1 to <18 years after single-limb-fracture surgery at one urban tertiary-care children's hospital in New York; 59 (19%) LEP vs 247 EP.

"A total of 337 patients were examined. Of these, 306 met inclusion criteria, of which 59 (19%) were in families with LEP." (Plancarte, 2021, p. 1201)

Other Notes #

Table 3 counts: 79/247 (32%) EP vs 18/59 (31%) LEP given floor opioids (P = .80).

Caveats #

• Opioid and 24-hour null findings may be underpowered given few opioid recipients and wide confidence intervals The opioid-related and 24-hour null findings should not be read as evidence of no effect. Only 66 of 306 patients (22%) received any opioid within 12 hours, and the LEP subgroup is small (n = 59), so these comparisons are likely underpowered. This is reflected in the very wide confidence interval on the unadjusted time-to-first-opioid hazard ratio (0.16–1.40), which spans large effects in both directions. The point estimates for opioids are directionally consistent with the significant analgesia disparity (LEP received opioids less often: 17% vs 23%; HR < 1), so absence of significance may reflect low power rather than true equivalence.