title: Impact of Age on Pain Perception for Typical Painful Diagnoses in the Emergency Department.
abstract: BACKGROUND
  Age-related differences in pain perception have been demonstrated in experimental settings but have been investigated scarcely and without valid scale in the clinical framework.
  
  
  OBJECTIVE
  To examine the effect of age on pain perception for recognized painful diagnoses encountered in the emergency department (ED).
  
  
  METHODS
  A post-hoc analysis of real-time archived data was performed in a tertiary urban and a secondary regional ED. We included all consecutive adult patients (≥18 years) with the following diagnosis at discharge: renal colic, pancreatitis, appendicitis, headache/migraine, dislocation and extremities fractures, and a pain evaluation of ≥1 (0-10, verbal numerical scale) at triage. The primary outcome was to compare for each of these diagnoses the level of pain intensity between four age groups (18-44; 45-64; 65-74; 75+ years).
  
  
  RESULTS
  A total of 15,670 patients (48% women) were triaged with a mean pain intensity of 7.7 (SD=2.0). Women exhibited greater pain scores than men for pancreatitis, headache/migraine, and extremity fracture. Renal colic, pancreatitis, appendicitis, and headache/migraine showed a linear decrease in pain scores with age whereas dislocation and extremity fractures did not present age differences. Mean differences in pain intensity scores between young adults (18-44 years) and patients aged ≥75 years were 0.79 (95% confidence interval [95% CI] 0.5-1.1) for renal colic, 1.1 (95% CI 0.7-1.4) for pancreatitis, 0.70 (95% CI 0.2-1.2) for appendicitis, and 0.86 (95% CI 0.6-1.1) for headache/migraine.
  
  
  CONCLUSIONS
  Older patients perceive similar pain for dislocation and extremity fractures and less for visceral and headache/migraine pain; however, these age differences may not be clinically important.
authors.affiliation: Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Raoul
authors.initials: R
authors.lastname: Daoust
authors.affiliation: Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Paquet
authors.affiliation: Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Éric
authors.initials: É
authors.lastname: Piette
authors.affiliation: Department of Emergency Medicine, Hôpital régional de St-Jérôme, St-Jérôme, Québec, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Sanogo
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Division of Emergency Medicine, Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec, Canada.
authors.forename: Benoit
authors.initials: B
authors.lastname: Bailey
authors.affiliation: Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chauny
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D001064:Appendicitis / Q000523:psychology; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000523:psychology; D006261:Headache / Q000523:psychology; D006801:Humans; D004204:Joint Dislocations / Q000523:psychology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology; D010147:Pain Measurement; D058748:Pain Perception; D010195:Pancreatitis / Q000523:psychology; D056844:Renal Colic / Q000523:psychology; D055815:Young Adult
keywords: age difference; emergency medicine; pain perception