Hwang Ula, Belland Laura K, Handel Daniel A, Yadav Kabir, Heard Kennon, Rivera-Reyes Laura, Eisenberg Amanda, Noble Matthew J, Mekala Sudha, Valley Morgan, Winkel Gary, Todd Knox H, Morrison Sean R
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY, USA Medical University of South Carolina, Charleston, SC, USA Department of Emergency Medicine, Oregon Health & Science University, Portland, SC, USA Department of Emergency Medicine, George Washington University Medical Center, Washington, DC, USA Department of Emergency Medicine, University of Colorado, Aurora, CO, USA Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Pain. 2014 Dec;155(12):2568-2574. doi: 10.1016/j.pain.2014.09.017. Epub 2014 Sep 20.
Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (⩾ 65 years) and oldest (⩾ 85 years) were less likely to receive analgesics compared to younger patients (<65 years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain.
疼痛在医疗环境中极为普遍;然而,疼痛护理治疗方面的差异依然存在。很少有研究调查过基于与衰老相关的患者特征是否存在差异。本研究的目的是确定老年患者与年轻患者在急性疼痛护理方面是否存在差异。这是一项对美国5个急诊科进行的多中心、回顾性、横断面观察研究,评估老年人最常出现的两种疼痛情况,即腹痛和骨折疼痛。完成了多变量调整分层建模。共审查了6948次就诊情况。与年轻患者(<65岁)相比,老年(⩾65岁)和高龄(⩾85岁)患者接受镇痛药治疗的可能性较小,但老年患者最终疼痛评分的降幅更大。在评估疼痛治疗和最终疼痛评分时,差异似乎基于疼痛类型。与年轻患者相比,腹痛老年患者接受止痛药物治疗的可能性较小,而骨折老年患者接受镇痛药和阿片类药物治疗的可能性更大。老年患者疼痛护理的差异似乎是由所呈现的疼痛类型驱动的。