title: Race, ethnicity, and management of pain from long-bone fractures: a prospective study of two academic urban emergency departments.
abstract: OBJECTIVE
  The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs).
  
  
  METHODS
  This was a prospective observational study of a convenience sample of patients with long-bone fractures from April 2002 to November 2006 in two academic urban EDs. Eligibility criteria were age 18-55 years, isolated long-bone fracture, and race and ethnicity (Hispanic, African American, and white). The primary outcome was receipt of analgesics; secondary outcomes included receipt of opioids, dose, route, time to first analgesic, and change in pain. Logistic regression was used to adjust the risk of receiving analgesics for patients' initial rating of pain and demographic characteristics.
  
  
  RESULTS
  Of 1,239 patients with suspected long-bone fractures, 345 patients were eligible: 177 (51%) were Hispanic, 98 (28%) were African American, and 70 (20%) were white. Administration of analgesics was not associated with race or ethnicity. Sixteen percent (95% confidence interval [CI] = 11% to 22%) of Hispanic, 15% (95% CI = 10% to 24%) of African American, and 14% (95% CI = 8% to 24%) of white patients did not receive any analgesics. Seventy-four percent of Hispanic (95% CI = 67% to 80%), 66% of African American (95% CI = 57% to 75%), and 69% (95% CI = 57% to 78%) of white patients received opioid analgesics. After adjustment for covariates, there was no evidence of an association between receipt of analgesics or opioid analgesics and the race or ethnicity of the patients. There were no significant differences in time to treatment, dose, route, or change in pain.
  
  
  CONCLUSIONS
  Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.
authors.affiliation: Department of Emergency Medicine, Albert Einstein College of Medicine Bronx, NY, USA. bijur@aecom.yu.edu
authors.forename: Polly
authors.initials: P
authors.lastname: Bijur
authors.forename: Anick
authors.initials: A
authors.lastname: Bérard
authors.forename: David
authors.initials: D
authors.lastname: Esses
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon
authors.forename: E John
authors.initials: EJ
authors.lastname: Gallagher
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006786:Hospitals, Urban; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000208:ethnology* / Q000209:etiology; D011446:Prospective Studies
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid