Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients A Nationwide Examination
Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients A Nationwide Examination
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DOI：
10.1097/mlr.0000000000000444
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发表时间：
2015-12-01
期刊：
影响因子：
3
通讯作者：
Haider, Adil H.
中科院分区：
文献类型：
--
作者：
Shah, Adil A.;Zogg, Cheryl K.;Haider, Adil H.
背景：先前的研究急性腹痛提供了相互矛盾的数据，关于存在种族/民族差异在急诊科（艾德）。目的：为了评估种族/民族为基础的差异，在艾德镇痛疼痛管理之间的全国样本的成人患者急性腹痛的基础上统一definition.Research设计/主题/措施：2006-2010年的CDC-NHAMCS数据进行了回顾性查询的患者18岁及以上的主要诊断为非创伤性急性腹痛的定义由美国创伤外科协会。确定了镇痛药/麻醉药特异性镇痛药接受的独立预测因素。然后进行风险调整的多变量分析，以确定种族/民族和止痛剂接受之间的关联。分层分析根据患者报告的疼痛水平考虑了风险调整后的差异。次要结局包括：结果：共纳入6710例艾德就诊患者：61.2%（n=4106）非西班牙裔白人，20.1%（n=1352）非西班牙裔白色，14.0%（n=939）西班牙裔和4.7%（n=313）其他种族/民族患者。相对于非西班牙裔白色患者，非西班牙裔黑人患者和其他人种/种族患者接受镇痛药的风险调整后几率低22%-30%[OR（95% CI）=0.78（0.67-0.90）; 0.70（0.56-0.88）]。他们接受麻醉性镇痛药的风险调整后的几率降低了17%-30%（P
Background:Prior studies of acute abdominal pain provide conflicting data regarding the presence of racial/ethnic disparities in the emergency department (ED).Objective:To evaluate race/ethnicity-based differences in ED analgesic pain management among a national sample of adult patients with acute abdominal pain based on a uniform definition.Research Design/Subjects/Measures:The 2006-2010 CDC-NHAMCS data were retrospectively queried for patients 18 years and above presenting with a primary diagnosis of nontraumatic acute abdominal pain as defined by the American Association for the Surgery of Trauma. Independent predictors of analgesic/narcotic-specific analgesic receipt were determined. Risk-adjusted multivariable analyses were then performed to determine associations between race/ethnicity and analgesic receipt. Stratified analyses considered risk-adjusted differences by the level of patient-reported pain on presentation. Secondary outcomes included: prolonged ED-LOS (>6 h), ED wait time, number of diagnostic tests, and subsequent inpatient admission.Results:A total of 6710 ED visits were included: 61.2% (n=4106) non-Hispanic white, 20.1% (n=1352) non-Hispanic black, 14.0% (n=939) Hispanic, and 4.7% (n=313) other racial/ethnic group patients. Relative to non-Hispanic white patients, non-Hispanic black patients and patients of other races/ethnicities had 22%-30% lower risk-adjusted odds of analgesic receipt [OR (95% CI)=0.78 (0.67-0.90); 0.70 (0.56-0.88)]. They had 17%-30% lower risk-adjusted odds of narcotic analgesic receipt (P