title: Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture: a multicenter exploratory study.
abstract: BACKGROUND
  Older people who present to the emergency department (ED) often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture.
  
  
  METHODS
  The aim of the study was to determine if cognitive impairment is associated with a delayed analgesic response. A 12-month exploratory study, using patient data, was conducted across four EDs. Medical records of 264 patients with long bone fractures were randomly selected.
  
  
  RESULTS
  The majority of patients waited longer than 60 minutes for analgesia. The median time to analgesia was longer for the cognitively impaired (149 minutes) compared with cognitively intact (72 minutes; Mann-Whitney U test:p< 0.001).
  
  
  CONCLUSIONS
  This study suggests that cognitive impairment is a significant risk factor for delayed analgesia response in the ED.
authors.affiliation: Research and Practice Development, Northern Sydney Local Health District, St Leonards, NSW, Australia.|School of Nursing, University of Sydney, Sydney, NSW, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, WA, Australia.
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
authors.affiliation: Aged and Extended Care Nursing, University of Technology, Sydney, NSW, Australia.|Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
authors.affiliation: Research and Practice Development, Northern Sydney Local Health District, St Leonards, NSW, Australia.
authors.forename: Casimir
authors.initials: C
authors.lastname: MacGregor
keywords: analgesia; dementia; emergency departments; geriatrics; mild cognitive impairment; musculoskeletal conditions; pain management