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Racial Disparities in Opioid Analgesia Administration Among Adult Emergency Department Patients with Abdominal Pain.
Jarman, Angela F; Hwang, Alexander C; Schleimer, Julia P; Fontenette, Roderick W; Mumma, Bryn E.
Afiliación
  • Jarman AF; University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California.
  • Hwang AC; University of California, Davis School of Medicine, Department of Emergency Medicine, Davis, California.
  • Schleimer JP; David Grant Medical Center, Travis Air Force Base, Fairfield, California.
  • Fontenette RW; University of California, Davis School of Medicine, Violence Prevention Research Program, Department of Emergency Medicine, Davis, California.
  • Mumma BE; University of California, Davis, University of California Firearm Violence Research Center, Davis, California.
West J Emerg Med ; 23(6): 826-831, 2022 Oct 24.
Article en En | MEDLINE | ID: mdl-36409944
INTRODUCTION: Racial disparities in pain management have been reported among emergency department (ED) patients. In this study we evaluated the association between patients' self-identified race/ethnicity and the administration of opioid analgesia among ED patients with abdominal pain, the most common chief complaint for ED presentations in the United States. METHODS: This was a retrospective cohort study of adult (age ≥18 years) patients who presented to the ED of a single center with abdominal pain from January 1, 2019-December 31, 2020. We collected demographic and clinical information, including patients' race and ethnicity, from the electronic health record. The primary outcome was the ED administration of any opioid analgesic (binary). Secondary outcomes included the administration of non-opioid analgesia (binary) and administration of any analgesia (binary). We used logistic regression models to estimate odds ratios (OR) of the association between a patient's race/ethnicity and analgesia administration. Covariates included age, sex, initial pain score, Emergency Severity Index, and ED visits in the prior 30 days. Subgroup analyses were performed in non-pregnant patients, those who underwent any imaging study, were admitted to the hospital, and who underwent surgery within 24 hours of ED arrival. RESULTS: We studied 7,367 patients: 45% (3,314) were non-Hispanic (NH) White; 28% (2,092) were Hispanic/Latinx; 19% (1,384) were NH Black, and 8% (577) were Asian. Overall, 44% (3,207) of patients received opioid analgesia. In multivariable regression models, non-White patients were less likely to receive opioid analgesia compared with White patients (OR 0.73, 95% CI 0.65-0.83 for Hispanic/Latinx patients; OR 0.62, 95% CI 0.54-0.72 for Black patients; and OR 0.64, 95% CI 0.52-0.78 for Asian patients). Black patients were also less likely to receive non-opioid analgesia, and Black and Hispanic/Latinx patients were less likely than White patients to receive any analgesia. The associations were similar across subgroups; however, the association was attenuated among patients who underwent surgery within 24 hours of ED arrival. CONCLUSION: Hispanic/Latinx, Black, and Asian patients were significantly less likely to receive opioid analgesia than White patients when presenting to the ED with abdominal pain. Black patients were also less likely than White patients to receive non-opioid analgesia.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Analgésicos no Narcóticos / Analgesia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Equity_inequality Límite: Adolescent / Adult / Humans / Infant País/Región como asunto: America do norte Idioma: En Revista: West J Emerg Med Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Analgésicos no Narcóticos / Analgesia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Equity_inequality Límite: Adolescent / Adult / Humans / Infant País/Región como asunto: America do norte Idioma: En Revista: West J Emerg Med Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos