Oligoanalgesia in blunt geriatric trauma.

Background: Research suggests that older age can influence perception, assessment, and treatment of acute pain, resulting in inadequate pain control for geriatric patients.

Objective: The purpose of this study was to determine if geriatric trauma patients are less likely to receive analgesia in our emergency department (ED).

Methods: This retrospective chart review includes blunt trauma adult patients who presented to a Level I trauma center ED between June 1 and December 31, 2012. Age was categorized as ≥65 years old and 18-64 years old. χ(2) was used to analyze differences in patients receiving pain medication by age groups. Analysis excluded those with no or low pain. A logistic regression model estimated the odds ratio of analgesic use controlling for age, pain level, sex, race, alcohol, drugs, Glasgow Coma Scale, ED length of stay, and Injury Severity Score. T-test compared differences in analgesia administration time.

Results: Four hundred and sixty-three blunt trauma patients were included in the analysis. Seventy percent of those ≥65 years received analgesia, compared with 84% of those 18-64 years old (p < 0.01). The mean time to analgesia administration was 92 min (≥65 years) compared to 61 min (18-64 years) (p = 0.03). Those ≥65 years were 69% less likely (odds ratio = 0.31; 95% confidence interval 0.16-0.59) to receive analgesia compared to patients aged 18-64 years, after controlling for confounders.

Conclusions: Trauma patients ≥ 65 years of age are less likely to receive analgesia than the younger cohort in our ED and waited longer to get it.