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.