Thornton Hilary Sarah, Reynolds Joseph, Coats Timothy J
Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Br J Pain. 2018 Feb;12(1):58-63. doi: 10.1177/2049463717731898. Epub 2017 Sep 19.
Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week.
We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital. We noted the initial pain score and, if the initial score was ≥5, the final recorded pain score. We categorised attendances as 'illness' or 'injury'.
In all, 62.1% of patients had a pain score recorded, of whom 50.7% had a pain score of zero. Median pain score was 6/10 in patients with pain; 58% had a second score recorded. More patients with illness than injury had a second score recorded. Most patients had an improvement in their pain; however, around one-third had no change or worse pain at the end of their ED stay.
We have defined the incidence, severity and change in pain in an ED over 1 week. This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice.
疼痛是急诊科患者的常见主诉，从历史上看，其评估不足且治疗不充分。以往的研究参差不齐，未能很好地描述急诊科随时间推移的疼痛情况。我们的目的是使用一个包含一周内所有成年就诊者的样本，来描述英国一家急诊科的疼痛情况。
我们回顾性分析了一家大型英国国民健康服务体系（NHS）区级综合医院急诊科一周内的所有成年就诊者（N = 1872）。我们记录了初始疼痛评分，如果初始评分≥5，则记录最终疼痛评分。我们将就诊情况分为“疾病”或“损伤”两类。
总体而言，62.1%的患者记录了疼痛评分，其中50.7%的患者疼痛评分为零。有疼痛的患者疼痛评分中位数为6/10；58%的患者记录了第二个评分。记录第二个评分的疾病患者多于损伤患者。大多数患者的疼痛有所改善；然而，约三分之一的患者在急诊科就诊结束时疼痛没有变化或加重。
我们确定了急诊科一周内疼痛的发生率、严重程度及变化情况。这些信息将为今后旨在改善急诊医学实践这一重要领域患者护理的研究设计提供依据。
