Racial disparities in analgesic use amongst patients presenting to the emergency department for kidney stones in the United States.

Abstract

INTRODUCTION:

We sought quantify racial disparities in use of analgesia amongst patients seen in Emergency Departments for renal colic.

METHODS:

We identified all individuals presenting to the Emergency Department with urolithiasis from 2003 to 2015 in the nationally representative Premier Hospital Database. We included patients discharged in ≤1 day and excluded those with chronic pain or renal insufficiency. We assessed the relationship between race/ethnicity and opioid dosage in morphine milligram equivalents (MME), and ketorolac, through multivariable regression models adjusting for patient and hospital characteristics.

RESULTS:

The cohort was 266,210 patients, comprised of White (84%), Black (6%) and Hispanic (10%) individuals. Median opioid dosage was 20 MME and 55.5% received ketorolac. Our adjusted model showed Whites had highest median MME (20 mg) with Blacks (-3.3 mg [95% CI: -4.6 mg to -2.1 mg]) and Hispanics (-6.0 mg [95% CI: -6.9 mg to -5.1 mg]) receiving less. Blacks were less likely to receive ketorolac (OR: 0.72, 95% CI: 0.62-0.84) while there was no difference between Whites and Hispanics.

CONCLUSIONS:

Black and Hispanic patients in American Emergency Departments with acute renal colic receive less opioid medication than White patients; Black patients are also less likely to receive ketorolac.

• Authors: Alexandra Joice Berger, Ye Wang, Courtney Rowe, Benjamin Chung, Steven Chang, George Haleblian
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 39 Pg. 71-74 (01 2021) ISSN: 1532-8171 [Electronic] United States
• PMID: 31987745 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Analgesics

Topics

• Aged
• Aged, 80 and over
• Analgesia (statistics & numerical data)
• Analgesics (therapeutic use)
• Cohort Studies
• Databases, Factual
• Emergency Service, Hospital
• Ethnicity
• Female
• Healthcare Disparities (statistics & numerical data)
• Humans
• Kidney Calculi (complications)
• Logistic Models
• Male
• Middle Aged
• Pain Management
• Practice Patterns, Physicians' (statistics & numerical data)
• Renal Colic (drug therapy)
• United States