Evidence map›Paper›PMID 27241564›Full record

Observational studyThe American journal of emergency medicine2016

The effect of surgical consult in the treatment of abdominal pain in older adults in the ED.

Eleanor S Roberts, Laura Belland, Laura Rivera-Reyes, Ula Hwang

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in The American journal of emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 94% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Eleanor S RobertsDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1062, New York, NY, 10029. Electronic address: Eleanor.roberts@icahn.mssm.edu.
Laura BellandDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1062, New York, NY, 10029; Center for Family and Community Medicine, Columbia University Medical Center, 610 W 158th St, New York, NY, 10032.
Laura Rivera-ReyesDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1062, New York, NY, 10029.
Ula HwangDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1062, New York, NY, 10029; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Geriatrics Research, Education and Clinical Center, James J Peters VAMC, Bronx, NY.
Icahn School of Medicine at Mount Sinai · US

Funding

Improving management of acute pain for older adults in the ED settingR21AG040734 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI HWANG, ULA Y · 2012 to 2013
$453k
NIA NIH HHS R21 AG040734
6 · The paper itself

Abstract

objectiveThe objective was to determine whether need for surgical consult contributes to delayed or reduced analgesic administration in older adults presenting to the emergency department with abdominal pain.

methodsSecondary data analyses from a prospective cohort study consisting of adults ≥65 years in age presenting to the emergency department with a chief concern of abdominal pain from November 1, 2012, through October 31, 2014, were performed. Measurements included administration of analgesics, time to administration, type given, and pain score reduction. Covariates for adjusted analyses included age, sex, race/ethnicity, and Emergency Severity Index.

resultsA total of 3522 patients were included, of which 281 (8.7%) received any consult. Consult patients were less likely to receive any analgesic medication (53.0%) compared with nonconsult patients (62.5%) (relative risk = 0.80; 95% confidence interval, 0.70-0.91). However, among those patients receiving analgesic medications, there were no differences in likelihood of receiving an opioid, time to administration, or pain score reduction. When analyzing patients who received a surgical consult (n = 154, 4.4%), these associations were notably stronger. Surgical consult patients had a lower rate of analgesic administration (46.8%) compared with nonconsult patients (62.4%) (relative risk = 0.75; 95% confidence interval, 0.63- 0.89). Again, no differences were found in likelihood of receiving any opioid, time to administration, or pain score reduction.

conclusionNeed for abdominal surgical consult is associated with decreased administration of analgesics in older patients, possibly indicating a continued need to improve management in this setting. This difference, however, did not impact pain score reductions.

Indexed as

Emergency Service, HospitalPain MeasurementReferral and ConsultationAbdominal PainAgedDiagnosis, DifferentialFemaleHumansMalePain ManagementProspective StudiesSurgeons

Identifiers

PMID27241564
PMCPMC5027841
OpenAlexW2371050066

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.