Harmon Erin Y, Chong Li Shen, Marruso Morgan D
James A. Eddy Research Institute, Sunnyview Rehabilitation Hospital.
Department of Psychology, University of Albany, State University of New York.
Rehabil Psychol. 2025 Feb;70(1):46-54. doi: 10.1037/rep0000560. Epub 2024 Apr 22.
Effective pain management is vital for hip fracture recovery, yet the factors influencing pain reporting and pain medication use during inpatient rehabilitation for hip fractures are not well understood. This observational study aimed to (a) determine how cognitive abilities, expressive and receptive language abilities, and age are related to average daily pain intensity and analgesic use and (b) how average daily pain intensity and analgesic use are related to length of stay and functional outcomes in rehabilitation.
Data were retrospectively obtained from 163 patients recovering from unilateral trochanteric fractures of the femur.
During the first week of rehabilitation, patients received a daily average of 1,147.8 ± 978 mg of acetaminophen and a morphine milligram equivalent of 15.3 ± 18.2. Multivariable regression revealed independent relationships between more intact general cognitive abilities ( = -0.40, 95% CI [-0.70, -0.11]), and older age ( = -0.41, 95% CI [-0.70, -0.11]) with lower average daily pain intensity. Higher average daily pain intensity ( = 0.97, 95% CI [0.75, 1.20]) was independently related to greater opioid use. The length of stay was shorter among patients administered higher daily doses of acetaminophen ( = 0.03, 95% CI [-0.05, -0.01]). Average daily pain intensity and analgesic use were not related to functional outcomes in multivariable models.
These findings inform the considerations for assessing and treating pain during inpatient rehabilitation. Supplemental strategies for assessing pain in older patients and alternative pain mitigation strategies for patients with impaired cognitive abilities should be considered. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
有效的疼痛管理对髋部骨折的恢复至关重要，但对于髋部骨折住院康复期间影响疼痛报告和止痛药物使用的因素，人们尚未完全了解。这项观察性研究旨在：（a）确定认知能力、表达和接受语言能力以及年龄与每日平均疼痛强度和止痛药物使用之间的关系；（b）确定每日平均疼痛强度和止痛药物使用与康复住院时间及功能结局之间的关系。
回顾性收集了163例单侧股骨转子间骨折康复患者的数据。
在康复的第一周，患者每天平均服用1147.8±978毫克对乙酰氨基酚，吗啡毫克当量为15.3±18.2。多变量回归显示，一般认知能力更强（β = -0.40，95%置信区间[-0.70，-0.11]）以及年龄较大（β = -0.41，95%置信区间[-0.70，-0.11]）与较低的每日平均疼痛强度独立相关。较高的每日平均疼痛强度（β = 0.97，95%置信区间[0.75，1.20]）与更多的阿片类药物使用独立相关。每日服用对乙酰氨基酚剂量较高的患者住院时间较短（β = 0.03，95%置信区间[-0.05，-0.01]）。在多变量模型中，每日平均疼痛强度和止痛药物使用与功能结局无关。
这些发现为住院康复期间疼痛的评估和治疗提供了参考。应考虑针对老年患者评估疼痛的补充策略以及针对认知能力受损患者的替代疼痛缓解策略。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
