Research Department, Prehospital Emergency Medical Service, Central Denmark Region, Aarhus, Denmark.
Department of Anesthesiology, Regional Hospital of Horsens, Horsens, Denmark.
Scand J Trauma Resusc Emerg Med. 2018 Jul 3;26(1):53. doi: 10.1186/s13049-018-0521-2.
Acute pain is a frequent symptom, but little is known about the frequency and causes of acute pain in the prehospital population. The objectives of this study were to investigate the frequency of moderate to severe pain among prehospital patients and the underlying causes according to primary hospital diagnose codes.
This was a register-based study on 41.241 patients transported by ambulance. Information on moderate to severe pain [Numeric Rating Scale (NRS, 0-10) > 3 or moderate pain or higher on 4-point likert scale] was extracted from a national electronic prehospital patient record. Patient information was merged with primary hospital diagnose codes based on the 10th version of the International Classification of Diseases (ICD-10) to investigate underlying causes of pain.
11.430 patients (27.7%) reported moderate to severe pain during ambulance transport. As a measure of opioid demanding acute pain, 3.275 of 41.241 patients (7.9%) were treated with intravenous fentanyl. Underlying causes of pain were heterogenic according to ICD-10 chapters with injuries being the largest group of patients with moderate to severe pain (XIX: 42.8% of 8.041 patients), followed by non-specific diagnoses (XVIII: 28.5% of 7.101 patients and XXI: 31.6% of 5.148 patients), diseases of the circulatory system (IX: 22.1% of 4.812 patients) and other (20.3% of 16.139 miscellaneous patients).
Due to the high frequency of moderate to severe pain affecting a wide range of patients, more attention on acute pain is necessary. Whether ambulance personnel have sufficient options for treating various pain conditions might be a subject of future evaluation. Non-specific diagnoses accounted for surprisingly many patients with moderate to severe pain, of which many were treated with intravenous fentanyl. This may be substance of further investigation.
Moderate to severe pain is a highly frequent and probably underestimated symptom among patients transported by ambulance. Underlying causes of pain are heterogenic as described by primary hospital diagnose codes. More focus on the treatment of acute pain is needed.
急性疼痛是一种常见症状，但对于院前人群中急性疼痛的频率和原因知之甚少。本研究的目的是根据主要医院诊断代码调查院前患者中度至重度疼痛的频率及其潜在原因。
这是一项基于 41241 名通过救护车转运的患者的登记研究。从中提取中度至重度疼痛（数字评分量表（NRS，0-10）>3 或 4 分制中度或更高疼痛）的信息）来自国家电子院前患者记录。根据国际疾病分类第 10 版（ICD-10），将患者信息与主要医院诊断代码合并，以调查疼痛的潜在原因。
在救护车转运过程中，11430 名（27.7%）患者报告有中度至重度疼痛。作为阿片类药物需求性急性疼痛的一种衡量标准，41241 名患者中有 3275 名（7.9%）接受了静脉注射芬太尼治疗。根据 ICD-10 章节，疼痛的潜在原因具有异质性，损伤是中度至重度疼痛患者最大的群体（XIX：8041 名患者中的 42.8%），其次是非特异性诊断（XVIII：7101 名患者中的 28.5%和 XXI：5148 名患者中的 31.6%）、循环系统疾病（IX：4812 名患者中的 22.1%）和其他（16139 名杂项患者中的 20.3%）。
由于中度至重度疼痛的频率较高，影响范围广泛，因此需要更多关注急性疼痛。救护车人员是否有足够的选择来治疗各种疼痛情况可能是未来评估的一个主题。非特异性诊断出乎意料地涉及许多患有中度至重度疼痛的患者，其中许多患者接受了静脉注射芬太尼治疗。这可能是进一步调查的内容。
中度至重度疼痛是救护车转运患者中一种高度常见且可能被低估的症状。疼痛的潜在原因是由主要医院诊断代码描述的异质性。需要更加关注急性疼痛的治疗。
