title: Pain Assessment and Control in the Injured Elderly.
abstract: Elderly trauma patients may be at increased risk for underassessment and inadequate pain control in the emergency department (ED). We sought to characterize risk factors for oligoanalgesia in the ED in elderly trauma patients and determine whether it impacts outcomes in elderly trauma patients. We included elderly patients (age ≥55 years) with Glasgow Coma Scale scores 13 to 15 and Injury Severity Score (ISS) ≥9 admitted through the ED at a Level I trauma center. Patient characteristics and outcomes were compared between those who reported pain and received analgesics medication in the ED (MED) and those who did not (NO MED). A total of 183 elderly trauma patients were identified over a three-year study period, of whom 63 per cent had pain assessed via verbal pain score; of those who reported pain, 73 per cent received analgesics in the ED. The MED and NO MED groups were similar in gender, race, ED vitals, ISS, and hospital length of stay. However, NO MED was older, with higher head Abbreviated Injury Scale score and longer intensive care unit length of stay. Importantly, as patients aged they reported lower pain and were less likely to receive analgesics at similar ISS. Risk factors for oligoanalgesia may include advanced age and head injury.
authors: Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors: Ara
authors: A
authors: Ko
authors: Megan Y
authors: MY
authors: Harada
authors: Eric J T
authors: EJ
authors: Smith
authors: Michael
authors: M
authors: Scheipe
authors: Rodrigo F
authors: RF
authors: Alban
authors: Nicolas
authors: N
authors: Melo
authors: Daniel R
authors: DR
authors: Margulies
authors: Eric J
authors: EJ
authors: Ley
mesh_terms: D059787:Acute Pain / Q000188:drug therapy* / Q000209:etiology; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis
chemical_list: D000700:Analgesics