- 作者：Raoul Daoust ; MD ; MSc&lowast ; ; &dagger ; ; ; Jean Paquet ; PhD&lowast ; ; &Dagger ; ; É ; ric Piette ; MD ; MSc&lowast ; ; &dagger ; ; Karine Sanogo ; MD§ ; ; Benoit Bailey ; MD ; MSc&dagger ; ; ¶ ; ; Jean-Marc Chauny ; MD ; MSc&lowast ; ; &dagger ;
- 关键词：pain perception ; age difference ; emergency medicine
- 刊名：Journal of Emergency Medicine
- 出版年：2016
- 出版时间：January 2016
- 年：2016
- 卷：50
- 期：1
- 页码：14-20
- 全文大小：474 K
Objectives
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.
Conclusion
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.