title: Oligoanalgesia in blunt geriatric trauma.
abstract: BACKGROUND
  Research suggests that older age can influence perception, assessment, and treatment of acute pain, resulting in inadequate pain control for geriatric patients.
  
  
  OBJECTIVE
  The purpose of this study was to determine if geriatric trauma patients are less likely to receive analgesia in our emergency department (ED).
  
  
  METHODS
  This retrospective chart review includes blunt trauma adult patients who presented to a Level I trauma center ED between June 1 and December 31, 2012. Age was categorized as ≥65 years old and 18-64 years old. χ(2) was used to analyze differences in patients receiving pain medication by age groups. Analysis excluded those with no or low pain. A logistic regression model estimated the odds ratio of analgesic use controlling for age, pain level, sex, race, alcohol, drugs, Glasgow Coma Scale, ED length of stay, and Injury Severity Score. T-test compared differences in analgesia administration time.
  
  
  RESULTS
  Four hundred and sixty-three blunt trauma patients were included in the analysis. Seventy percent of those ≥65 years received analgesia, compared with 84% of those 18-64 years old (p < 0.01). The mean time to analgesia administration was 92 min (≥65 years) compared to 61 min (18-64 years) (p = 0.03). Those ≥65 years were 69% less likely (odds ratio = 0.31; 95% confidence interval 0.16-0.59) to receive analgesia compared to patients aged 18-64 years, after controlling for confounders.
  
  
  CONCLUSIONS
  Trauma patients ≥ 65 years of age are less likely to receive analgesia than the younger cohort in our ED and waited longer to get it.
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Erin
authors: E
authors: Quattromani
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Daniel
authors: D
authors: Normansell
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Michelle
authors: M
authors: Storkan
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Grant
authors: G
authors: Gerdelman
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Semeon
authors: S
authors: Krits
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Charles
authors: C
authors: Pennix
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: David
authors: D
authors: Sprowls
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Eric
authors: E
authors: Armbrecht
authors: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors: Preeti
authors: P
authors: Dalawari
mesh_terms: D059787:Acute Pain / Q000188:drug therapy* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014193:Trauma Centers / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: blunt trauma; emergency department; geriatrics; morphine equivalents; oligoanalgesia