Department of Emergency Medicine, Northside Hospital Forsyth, Cumming, GA 30041, USA.
Am J Emerg Med. 2012 Feb;30(2):331-7. doi: 10.1016/j.ajem.2010.12.015. Epub 2011 Mar 1.
Pain is a common presenting complaint among emergency department (ED) patients. The verbal numeric pain scale is commonly used in the ED to assess self-reported pain. This study was undertaken to describe and compare pain scores in a variety of painful conditions and identify factors associated with self-reported pain scores.
The study was a prospective, observational, descriptive survey study conducted at an urban university hospital ED. Eligible participants included consenting adults 18 years and older, with an acute painful condition, who spoke English, and were not in severe distress. Through a structured interview, collected data included pain score; diagnosis; medical history; previous painful experiences; and demographic information including age, insurance status, and highest level of education completed.
Among 268 eligible participants, 263 (98%) consented and completed the study protocol. Seventy-one percent of participants were 50 years old or younger; 55%, women; and 68%, white. Fifty-four percent had private insurance, and 81%, high school education or higher. The most common chief complaints were soft tissue injury (33%), abdominal pain (18%), and chest pain (13%). The median self-reported pain score was 7/10 (mean, 6.7; interquartile range, 6-9; range, 0-10). The most common previous painful experiences were childbirth (21%), major trauma (18%), and surgery (14%). Participants cited reasons for self-reported pain scores, including current feeling of pain (62%), comparison to previous pain (31%), and comparison to hypothetical pain (12%). The number of previous ED visits was positively correlated with current pain score (Spearman correlation R = 0.28; P < .001). The chief complaints associated with the highest pain scores included dental pain (mean pain score, 8.5) and back pain (mean pain score, 7.6). Chief complaints associated with the lowest pain scores included chest pain (mean pain score, 5.2) and other medical conditions (mean pain score, 5.3). Factors associated with higher pain scores included younger age (P < .001, Kruskal-Wallis), Medicaid insurance (P = .02), and lower educational status (P = .01). There was not a statistically significant association between current pain score and sex, race, previous painful experiences, or number of hospital admissions.
Emergency department patients with acute painful conditions report a wide range of self-reported pain scores. Participants rated pain based on current feeling of pain or comparison to previous or hypothetical pain. Chief complaints with highest pain scores included dental pain and back pain. Factors associated with higher pain scores included younger age, Medicaid insurance, lower educational status, and higher number of previous ED visits.
疼痛是急诊科（ED）患者常见的主诉。ED 中常用口述数字疼痛量表来评估自我报告的疼痛。本研究旨在描述和比较各种疼痛情况的疼痛评分，并确定与自我报告疼痛评分相关的因素。
该研究是一项在城市大学医院 ED 进行的前瞻性、观察性、描述性调查研究。符合条件的参与者包括同意的 18 岁及以上的成年人，他们有急性疼痛症状，会说英语，且没有严重的不适。通过结构化访谈收集的数据包括疼痛评分、诊断、病史、以前的疼痛经历以及包括年龄、保险状况和最高完成教育程度在内的人口统计学信息。
在 268 名符合条件的参与者中，263 名（98%）同意并完成了研究方案。71%的参与者年龄在 50 岁或以下；55%为女性；68%为白人。54%有私人保险，81%有高中或以上学历。最常见的主诉是软组织损伤（33%）、腹痛（18%）和胸痛（13%）。自我报告的疼痛评分中位数为 7/10（平均 6.7；四分位距 6-9；范围 0-10）。最常见的以前的疼痛经历是分娩（21%）、重大创伤（18%）和手术（14%）。参与者给出了自我报告疼痛评分的原因，包括当前的疼痛感觉（62%）、与以前的疼痛相比（31%）和与假设的疼痛相比（12%）。以前急诊就诊次数与当前疼痛评分呈正相关（Spearman 相关系数 R = 0.28；P <.001）。与最高疼痛评分相关的主要投诉包括牙痛（平均疼痛评分 8.5）和背痛（平均疼痛评分 7.6）。与最低疼痛评分相关的主要投诉包括胸痛（平均疼痛评分 5.2）和其他医疗状况（平均疼痛评分 5.3）。与更高疼痛评分相关的因素包括年龄较小（P <.001，Kruskal-Wallis）、医疗补助保险（P =.02）和较低的教育程度（P =.01）。当前疼痛评分与性别、种族、以前的疼痛经历或住院次数之间没有统计学上的显著关联。
有急性疼痛症状的急诊科患者报告了广泛的自我报告疼痛评分。参与者根据当前的疼痛感觉或与以前或假设的疼痛相比来评估疼痛。疼痛评分最高的主要投诉包括牙痛和背痛。与更高疼痛评分相关的因素包括年龄较小、医疗补助保险、较低的教育程度和以前急诊就诊次数较多。
