A Multicenter Evaluation of the Impact of Sex on Abdominal and Fracture Pain Care

Overview

Journal Med Care

Specialty Health Services

Date 2015 Oct 15

PMID 26465122

Citations 5

Authors

Ammar Siddiqui

Laura Belland

Laura Rivera-Reyes

Daniel Handel

Kabir Yadav

Kennon Heard

Amanda Eisenberg

Ula Hwang

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies examining sex-based disparities in emergency department (ED) pain care have been limited to a single pain condition, a single study site, and lack rigorous control for confounders.

Objective: A multicenter evaluation of the effect of sex on abdominal pain (AP) and fracture pain (FP) care outcomes.

Research Design: A retrospective cohort review of ED visits at 5 US hospitals in January, April, July, and October 2009.

Subjects: A total of 6931 patients with a final ED diagnosis of FP (n=1682) or AP (n=5249) were included.

Measures: The primary predictor was sex. The primary outcome was time to analgesic administration. Secondary outcomes included time to medication order, and the likelihood of receiving an analgesic and change in pain scores 360 minutes after triage: Multivariable models, clustered by study site, were conducted to adjust for race, age, comorbidities, initial pain score, ED crowding, and triage acuity.

Results: On adjusted analyses, compared with men, women with AP waited longer for analgesic administration [AP women: 112 (65-187) minutes, men: 96 (52-167) minutes, P<0.001] and ordering [women: 84 (41-160) minutes, men: 71 (32-137) minutes, P<0.001], whereas women with FP did not (Administration: P=0.360; Order: P=0.133). Compared with men, women with AP were less likely to receive analgesics in the first 90 minutes (OR=0.766; 95% CI, 0.670-0.875; P<0.001), whereas women with FP were not (P=0.357).

Discussion: In this multicenter study, we found that women experienced delays in analgesic administration for AP, but not for FP. Future research and interventions to decrease sex disparities in pain care should take type of pain into account.

Citing Articles

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Vastola M, Mumma B, Fine J, Tancredi D, Elder J, Jarman A JEM Rep. 2024; 3(1).

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Comparison of emergency department throughput and process times between male and female patients: A retrospective cohort investigation by the Reducing Disparities Increasing Equity in Emergency Medicine Study Group.

Onal E, Knier K, Hunt A, Knudsen J, Nestler D, Campbell R J Am Coll Emerg Physicians Open. 2022; 3(5):e12792.

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The roles of gender and profession on gender role expectations of pain in health care professionals.

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