基于性别的急诊科急性腹痛评估和管理差异：回顾性审计。

Gender-based differences in assessment and management of acute abdominal pain in the emergency department: A retrospective audit.

作者信息

Hayes Megan, Hutchinson Ana, Kerr Debra

机构信息

Cabrini Health, The Patricia Peck Education and Research Precinct, Australia; Epworth HealthCare, Emergency Department, Richmond, Victoria, Australia.

Deakin University, Institute of Health Transformation, Centre for Quality and Safety Research, Epworth HealthCare, Deakin University Partnership, Australia; Deakin University, School of Nursing & Midwifery, Burwood, Victoria, Australia.

出版信息

Australas Emerg Care. 2023 Dec;26(4):290-295. doi: 10.1016/j.auec.2023.03.001. Epub 2023 Mar 11.

DOI:10.1016/j.auec.2023.03.001

PMID:36914504

Abstract

BACKGROUND

Previous research has identified gender-based differences in acute pain management in the emergency department [ED]. The aim of this study was to compare pharmacological management of acute abdominal pain in the ED by gender.

METHODS

A retrospective chart audit was conducted at one private metropolitan ED including adult patients (18-80 years) who presented with acute abdominal pain in 2019. Exclusion criteria included: pregnancy, repeat presentation within the study period, pain-free at initial medical review or documented refusal of analgesia, and oligo-analgesia. Comparisons by gender included: (1) analgesia type and (2) time to analgesia. Bivariate analysis was undertaken using SPSS.

RESULTS

There were 192 participants: 61 (31.6 %) men and 131 (67.9 %) women. Men were more likely to get combined opioid and non-opioid medication as first line analgesia (men: 26.2 % n = 16; women: 14.5 % n = 19, p = .049). Median time from ED presentation to analgesia was 80 min for men (IQR: 60) versus 94 min for women (IQR: 58), (p = .119). Women (25.2 % n = 33) were more likely to receive their first analgesic after 90 min from ED presentation compared to men versus men (11.5 %, n = 7 p = .029). In addition, women waited longer before receiving second analgesia (women: 94, men: 30 min, p = .032).

CONCLUSION

Findings confirm there are differences in pharmacological management of acute abdominal pain in the ED. Larger studies are required to further explore differences observed in this study.

摘要

背景

先前的研究已经确定了急诊科急性疼痛管理方面的性别差异。本研究的目的是比较急诊科急性腹痛的药物治疗管理情况。

方法

对一家私人大都市急诊室进行回顾性图表审查，纳入 2019 年出现急性腹痛的成年患者（18-80 岁）。排除标准包括：妊娠、研究期间重复就诊、首次医疗评估时无痛或有记录的拒绝镇痛、以及镇痛不足。按性别进行比较包括：（1）镇痛类型和（2）镇痛时间。采用 SPSS 进行双变量分析。

结果

共有 192 名参与者：61 名（31.6%）男性和 131 名（67.9%）女性。男性更有可能首先使用阿片类药物和非阿片类药物联合治疗作为一线镇痛药物（男性：26.2%，n=16；女性：14.5%，n=19，p=0.049）。男性从急诊就诊到接受镇痛的中位数时间为 80 分钟（IQR：60），而女性为 94 分钟（IQR：58），（p=0.119）。与男性相比，女性在急诊就诊后 90 分钟后更有可能接受首次镇痛（女性：25.2%，n=33；男性：11.5%，n=7，p=0.029）。此外，女性在接受第二次镇痛之前等待的时间更长（女性：94 分钟，男性：30 分钟，p=0.032）。