A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization
Background: In the face of the opiate addiction epidemic, there is a paucity of research that evaluates limitations for our current pain rating methodologies for patient populations at risk for drug seeking behavior. Objective: We hypothesized that VAS scores would be higher and show less serial imp...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844021013190 |
| _version_ | 1818859011102998528 |
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| author | Ryan Joseph Alainya Tomanec Thomas McLaughlin Jose Guardiola Peter Richman |
| author_facet | Ryan Joseph Alainya Tomanec Thomas McLaughlin Jose Guardiola Peter Richman |
| author_sort | Ryan Joseph |
| collection | DOAJ |
| description | Background: In the face of the opiate addiction epidemic, there is a paucity of research that evaluates limitations for our current pain rating methodologies for patient populations at risk for drug seeking behavior. Objective: We hypothesized that VAS scores would be higher and show less serial improvement for patients with a history of frequent ED use. Methods: This was a prospective, observational cohort study of a convenience sample of adult ED patients with chief complaint of pain. Initial VAS scores were recorded. Pain scores were subsequently updated 30–45 min after pain medication administration. ED frequenter defined as having >4 ED visits over a 1-year time period. Categorical data analyzed by chi-square; continuous data analyzed by t-tests. A multiple linear regression performed to control for confounding. Results: 125 patients were enrolled; 51% ED frequenters. ED frequenters were similar to non-ED frequenters with respect to gender, mean age, Hispanic race, educational level, chief complaint type, and initial pain medication narcotic. ED frequenters more likely to have higher initial VAS score (9.17+/-1.25 vs. 8.51+/-1.68; p = 0.01) and higher second VAS scores (7.48+/-2.56 vs. 5.00+/-3.28; p <0.001) and significantly lower mean change in first to second VAS scores (1.69+/-2.17 vs. 3.51+/-3.25; p <0.001). Within our multiple linear regression model, only ED frequenter group (p < 0.001) and private insurance status (0.04) were associated with differences in mean reduction in pain scores. Conclusion: We found that ED frequenters had significantly less improvement between first and second VAS measurements. |
| first_indexed | 2024-12-19T09:05:24Z |
| format | Article |
| id | doaj.art-9729b8681a384336b8236ce8bfa6efe6 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-19T09:05:24Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-9729b8681a384336b8236ce8bfa6efe62022-12-21T20:28:21ZengElsevierHeliyon2405-84402021-06-0176e07216A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilizationRyan Joseph0Alainya Tomanec1Thomas McLaughlin2Jose Guardiola3Peter Richman4Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USADepartment of Emergency Medicine, CHRISTUS Health/Texas A&M, Corpus Christi, TX, USADepartment of Emergency Medicine, CHRISTUS Health/Texas A&M, Corpus Christi, TX, USADepartment of Mathematics, Texas A&M-Corpus Christi, Corpus Christi, TX, USADepartment of Emergency Medicine, CHRISTUS Health/Texas A&M, Corpus Christi, TX, USA; Corresponding author.Background: In the face of the opiate addiction epidemic, there is a paucity of research that evaluates limitations for our current pain rating methodologies for patient populations at risk for drug seeking behavior. Objective: We hypothesized that VAS scores would be higher and show less serial improvement for patients with a history of frequent ED use. Methods: This was a prospective, observational cohort study of a convenience sample of adult ED patients with chief complaint of pain. Initial VAS scores were recorded. Pain scores were subsequently updated 30–45 min after pain medication administration. ED frequenter defined as having >4 ED visits over a 1-year time period. Categorical data analyzed by chi-square; continuous data analyzed by t-tests. A multiple linear regression performed to control for confounding. Results: 125 patients were enrolled; 51% ED frequenters. ED frequenters were similar to non-ED frequenters with respect to gender, mean age, Hispanic race, educational level, chief complaint type, and initial pain medication narcotic. ED frequenters more likely to have higher initial VAS score (9.17+/-1.25 vs. 8.51+/-1.68; p = 0.01) and higher second VAS scores (7.48+/-2.56 vs. 5.00+/-3.28; p <0.001) and significantly lower mean change in first to second VAS scores (1.69+/-2.17 vs. 3.51+/-3.25; p <0.001). Within our multiple linear regression model, only ED frequenter group (p < 0.001) and private insurance status (0.04) were associated with differences in mean reduction in pain scores. Conclusion: We found that ED frequenters had significantly less improvement between first and second VAS measurements.http://www.sciencedirect.com/science/article/pii/S2405844021013190PainAnalgesicsVisual analog scalePain scoresPain medicationsEmergency department |
| spellingShingle | Ryan Joseph Alainya Tomanec Thomas McLaughlin Jose Guardiola Peter Richman A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization Heliyon Pain Analgesics Visual analog scale Pain scores Pain medications Emergency department |
| title | A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization |
| title_full | A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization |
| title_fullStr | A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization |
| title_full_unstemmed | A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization |
| title_short | A prospective study to compare serial changes in pain scores for patients with and without a history of frequent ED utilization |
| title_sort | prospective study to compare serial changes in pain scores for patients with and without a history of frequent ed utilization |
| topic | Pain Analgesics Visual analog scale Pain scores Pain medications Emergency department |
| url | http://www.sciencedirect.com/science/article/pii/S2405844021013190 |
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