The quality of emergency department pain care for older adult patients.
The quality of emergency department pain care for older adult patients.
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DOI：
10.1111/j.1532-5415.2010.03152.x
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发表时间：
2010-11
影响因子：
6.3
通讯作者：
Morrison RS
中科院分区：
文献类型：
--
作者：
Hwang U;Richardson LD;Harris B;Morrison RS
评价老年人与年轻人在急诊科（艾德）疼痛评估和治疗方面是否存在差异。回顾性观察队列。2005年7月至12月，城市、学术三级保健艾德。患有需要艾德疼痛护理的疾病的成人患者。年龄、Charlson合并症评分、既往用药次数、性别、人种/种族、分诊严重程度、疼痛程度、主治医生和最终艾德诊断。疼痛护理过程的措施是疼痛评估和治疗，活动时间。共有1，031例艾德访视符合入选标准。其中92%有记录的疼痛评估。在报告疼痛的患者中，41%进行了随访疼痛评估，59%接受了镇痛药物治疗（其中58%为阿片类药物，24%为非甾体抗炎药（NSAID））。在校正分析中，疼痛评估和接受任何止痛剂的年龄没有差异。与年轻患者（18-64岁）相比，老年患者（65-84岁）接受阿片类镇痛剂治疗中度至重度疼痛的可能性较小（OR= 0. 44，95% CI（0. 22，0. 88）），并且有更可能接受NSAID治疗轻度疼痛的趋势（OR= 3. 72，95% CI（0. 97，14. 24））。老年人从最初到最终记录的疼痛评分的降低程度较低（p<0.01）。老年人的急性艾德疼痛护理似乎存在差异。疼痛评分的总体降低和阿片类药物用于治疗老年患者疼痛状况的减少都突出了令人担忧的差异。未来的研究应确定这些差异是否代表艾德疼痛护理不足。
To evaluate if there are differences in emergency department (ED) pain assessment and treatment in older versus younger adults. Retrospective observational cohort. Urban, academic tertiary care ED during July and December 2005. Adult patients with conditions warranting ED pain care. Age, Charlson comorbidity score, number of prior medications, gender, race/ethnicity, triage severity, degree of pain, treating clinician, and final ED diagnosis. Pain care process measures were pain assessment and treatment, and time of activities. A total of 1,031 ED visits met inclusion criteria. Ninety-two percent of these had a documented pain assessment. Of those reporting pain, 41% had follow-up pain assessments and 59% received analgesic medication (58% of these as opioid, 24% as non-steroidal anti-inflammatory drug (NSAID)). In adjusted analyses, there were no differences by age in pain assessment and receiving any analgesic. Older patients (65–84 years) were less likely than younger patients (18–64 years) to receive opioid analgesics for moderate to severe (OR=0.44, 95% CI (0.22, 0.88)) and had a trend to more likely to receive NSAIDs for mild pain (OR=3.72, 95% CI (0.97, 14.24)). Older adults had a lower reduction of initial to final recorded pain scores (p<0.01). There appear to be differences in acute ED pain care for older adults. Both lower overall reduction of pain scores and decreased opioid use for the treatment of painful conditions in older patients highlight disparities of concern. Future studies should determine if these differences represent inadequate ED pain care.
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DOI：
10.1111/j.1532-5415.2006.00986.x
发表时间：
2006-12-01
影响因子：
6.3
作者：
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通讯作者：
Sachs, Greg A.
影响因子：
168.9
作者：
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通讯作者：
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影响因子：
5.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Glassman, P
影响因子：
1.7
作者：
Heins, Janet Kaye;Heins, Alan;Mishra, Satya
通讯作者：
Mishra, Satya