Oligoanalgesia in blunt geriatric trauma.

BACKGROUND

Research suggests that older age can influence perception, assessment, and treatment of acute pain, resulting in inadequate pain control for geriatric patients.

OBJECTIVE

The purpose of this study was to determine if geriatric trauma patients are less likely to receive analgesia in our emergency department (ED).

METHODS

This retrospective chart review includes blunt trauma adult patients who presented to a Level I trauma center ED between June 1 and December 31, 2012. Age was categorized as ≥65 years old and 18-64 years old. χ(2) was used to analyze differences in patients receiving pain medication by age groups. Analysis excluded those with no or low pain. A logistic regression model estimated the odds ratio of analgesic use controlling for age, pain level, sex, race, alcohol, drugs, Glasgow Coma Scale, ED length of stay, and Injury Severity Score. T-test compared differences in analgesia administration time.

RESULTS

Four hundred and sixty-three blunt trauma patients were included in the analysis. Seventy percent of those ≥65 years received analgesia, compared with 84% of those 18-64 years old (p < 0.01). The mean time to analgesia administration was 92 min (≥65 years) compared to 61 min (18-64 years) (p = 0.03). Those ≥65 years were 69% less likely (odds ratio = 0.31; 95% confidence interval 0.16-0.59) to receive analgesia compared to patients aged 18-64 years, after controlling for confounders.

CONCLUSIONS

Trauma patients ≥ 65 years of age are less likely to receive analgesia than the younger cohort in our ED and waited longer to get it.