Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure.
Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure.
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DOI：
10.1097/jcn.0000000000000878
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发表时间：
2022-09-01
影响因子：
2
通讯作者：
Pressler, Susan J.
中科院分区：
文献类型：
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作者：
Smith, Asa B.;Jung, Miyeon;Lee, Christopher;Pressler, Susan J.
疼痛是由紧急医疗服务（EMS）运送的心力衰竭（HF）患者中常见但未充分研究的症状。目的是确定疼痛和疼痛严重程度的主要主诉的解释因素，并描述EMS转运的HF患者的疼痛特征。分析了2009-2017年美国中西部一个县通过EMS运送的HF患者的电子健康记录数据。采用描述性统计、卡方检验、方差分析、Logistic和多元线性回归分析。样本（n = 4，663）主要为女性（58.1%），自我报告的种族为黑人（57.7%）。平均年龄为64.2 ± 14.3岁。疼痛是22.2%样本的主要主诉，平均疼痛评分为6.8 ± 3.1分（满分10分）。最常见的疼痛主诉是胸痛（68.1%）。与原发性疼痛主诉相关的因素是年龄较小（OR = 0.97，CI = 0.96 - 0.97）、心肌梗死史（OR = 1.96，CI = 1.55 - 2.49）和无呼吸短促（OR = 0.67，CI = 0.58 - 0.77）。与疼痛严重程度较高相关的因素是年龄较小（B =-0.05，SE = 0.013）、女性（B = 1.17，SE = 0.357）和白色（B =-1.11，SE = 0.349）。在了解EMS运输期间HF的疼痛时需要考虑临床和人口统计学因素。需要更多的研究来检查这些因素，以改善疼痛管理并减少疼痛引起的转运。
Pain is a common but understudied symptom among patients with heart failure (HF) transported by emergency medical services (EMS). The aims were to determine explanatory factors of a primary complaint of pain and pain severity, and characterize pain among patients with HF transported by EMS. Data from electronic health records of patients with HF transported by EMS within a midwestern United States county from 2009-2017 were analyzed. Descriptive statistics, Chi-square, analysis of variance, and logistic and multiple linear regression analyses were used. The sample (n = 4,663) was predominantly women (58.1%) with self-reported race as Black (57.7%). The mean age was 64.2 ± 14.3 years. Pain was the primary complaint in 22.2% of the sample, with an average pain score of 6.8 ± 3.1 out of 10. The most common pain complaint was chest pain (68.1%). Factors associated with a primary pain complaint were younger age (OR = 0.97, CI = 0.96 – 0.97), history of myocardial infarction (OR = 1.96, CI = 1.55 – 2.49), and the absence of shortness of breath (OR = 0.67, CI = 0.58 – 0.77). Factors associated with higher pain severity were younger age (b = −0.05, SE = 0.013), being a woman (b = 1.17, SE = 0.357), and White race (b = −1.11, SE = 0.349). Clinical and demographic factors need consideration in understanding pain in HF during EMS transport. Additional research is needed to examine these factors in order to improve pain management and reduce transports due to pain.