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Time from pain assessment to opioid treatment in the Danish emergency departments—A multicenter cohort study

Year: 2024

Type: article

Abstract: In this retrospective study of patients treated at Danish emergency departments, the authors studied time to opioid administration in patients with moderate to severe pain.They found slightly longer times to opioid administration in elderly female patients and those treated with paracetamol.The differences were on average nonetheless rather small. | INTRODUCTIONPain is one of the most common reasons for presentation in the emergency department (ED), 1,2 with up to 70% of all ED contacts being related to pain.[3][4][5] This makes pain treatment a core component of emergency medicine, yet it is often a challenge to ensure prompt, efficient, and safe pain management in the ED.6,7 Prior research indicates that several factors affect pain management in the ED including age, gender, and ethnicity.8 Time to analgesic administration has been previously investigated as an indicator of quality of care with results from previous studies varying significantly from 62 to 116 min.[9][10][11] To our knowledge, no previous studies have assessed time to opioid treatment as the primary outcome in a large multicenter population.In a nationwide survey from 2020, up to 50% of patients in Danish EDs reported insufficient pain management, 12 consistent with other European countries.13 Therefore, it is essential to investigate whether time to opioid treatment could be a reason for insufficient pain management, given that prior studies have predominantly concentrated on other analgesic interventions.Since the decision to administer opioids involves a higher level of clinical judgement due to potential risks, this study could provide a better understanding on how severe pain is being addressed and the timeliness of clinical decisions to administer opioids.Inadequate pain management can, besides the obvious discomfort, result in acute complications, prolonged hospital stays, demoralization, sleep deprivation, and slower wound healing.9,14 International guidelines state that patients should receive appropriate analgesia within 20-30 min of triage.2,9,13 The primary aim of the study was to investigate the time from pain assessment to first opioid treatment for pain requiring opioids (NRS ≥4) 13 in five Danish EDs among patients presenting with abdominal or flank pain, the most frequent presentation in the ED. 15 The secondary aim was to assess associations of known risk factors (age, gender, and other analgesic treatment) that could influence time to opioid treatment initiation. | METHODS | Study design and settingThis retrospective multicenter cohort study comprises patients from five Central Denmark Region (CDR) hospitals between February

Source: Acta Anaesthesiologica Scandinavica

DOI: 10.1111/aas.14544

Authors: Katrine H. Gull, Marianne Lisby, Sara V. Leth, Stine F. Galili

Institutions: Aarhus University, Aarhus University Hospital

Language: English

Topic: Emergency and Acute Care Studies

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,220