Visit Characteristics Associated With Opioids Administered or Prescribed During Emergency Department Visits for Ankle Sprain Between 2010 and 2015

Background: Recent research has demonstrated that patients with ankle sprain who are discharged from the emergency department (ED) are prescribed an opioid. Minimizing the exposure to opioids is important to help prevent future abuse and misuse of these medications. Objective: Identify ED visit characteristics for an ankle sprain that are associated with an opioid given in the ED, prescribed at discharge, or both. Design: Retrospective analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS). Setting: Hospital. Participants: Isolated ankle sprain visits to a United States ED. Main Outcome Measurements: The main outcome was an opioid given in the ED, prescribed at discharge, or both between 2010 and 2015. Explanatory variables included age, sex, race, attending physician or resident, and geographic location of the hospital. A multiple logistic regression was performed to assess the independent association between an opioid given in the ED, prescribed at discharge, or both, and all explanatory variables. The analysis accounted for the cluster, strata, and probability weights for each year of the NHAMCS. Results: Ankle sprain visits for patients ≤17 years of age had a lower odds of an opioid being given in the ED, prescribed at discharge, or both, compared to visits for patients 18 to 24 years of age (adjusted odds ratio [aOR] = 0.26 [95% confidence interval (CI) = 0.1, 0.5]; P <.001). Visits in the West (aOR = 2.5 [95% CI = 1.2, 5.4]) or South (aOR = 2.9 [95% CI = 1.6, 5.4]; P =.010) had higher odds of an opioid being given in the ED, prescribed at discharge, or both, compared to visits in the Northeast. Conclusions: Ankle sprain visits for patients ≤17 years of age had a lower odds of an opioid compared to visits for patients 18 to 24 years of age. Ankle sprain visits in the South or West had a higher odds of an opioid compared to visits in the Northeast. These findings provide a direction for future work aimed at minimizing exposure to opioids after an ankle sprain.