title: Postoperative Treatment of Pain after Hip Fracture in Elderly Patients with Dementia.
abstract: Prior studies have shown that patients with dementia are at risk of receiving insufficient treatment for pain after a hip fracture. We therefore hypothesized that elderly hip fracture patients with dementia received less postoperative pain treatment than those without dementia.
  
  
  
  All patients (age ≥65 years) who had been operated on for a hip fracture in the Copenhagen University Hospital region in 2009 were included. Data about analgesic use for the first 72 h after surgery were acquired from the hospitals' electronic medication system and linked with information about dementia, comorbidity, and prior drug use.
  
  
  
  A total of 1,507 patients were included, of which 296 (19.6%) suffered from dementia. Both groups were equally likely to receive paracetamol and opioids. Patients with dementia received lower doses of oral morphine equivalents during the first [dementia vs. no dementia: 29.0 (26.4-31.8) vs. 34.7 (33.1-36.4) mg, p = 0.001] and second [27.8 (25.4-30.5) vs. 31.2 (29.9-32.4) mg, p = 0.019] but not on the third postoperative day (p = 0.10).
  
  
  
  The lower doses of opioids may reflect uncertainty about how to treat pain patients with dementia. Further guidance is needed, as inadequate treatment of pain may have adverse consequences.
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Jensen-Dahm
authors.forename: Henrik
authors.initials: H
authors.lastname: Palm
authors.forename: Christiane
authors.initials: C
authors.lastname: Gasse
authors.forename: Jørgen B
authors.initials: JB
authors.lastname: Dahl
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D003704:Dementia / Q000150:complications*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000082:Acetaminophen