ArticleJournal of clinical medicine2021
Evaluating the 0-10 Point Pain Scale on Adolescent Opioid Use in US Emergency Departments.
Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Postoperative Opioid Consumption After Discharge: An Update From the Michigan Surgical Quality Collaborative Registry.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Self-reported pain levels for emergency department visits associated with sickle cell disease in the United States.Blood advances · 2024Article
- Characteristics of Emergency Department Visits Made by Individuals With Sickle Cell Disease in the U.S., 1999-2020.AJPM focus · 2024Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate trends in national emergency department (ED) adolescent opioid use in relation to reported pain scores.
methodsA retrospective, cross-sectional analysis on National Hospital Ambulatory Medical Care Survey (NHAMCS) data was conducted on ED visits involving patients aged 11-21 from 2008-2017. Crude observational counts were extrapolated to weighted estimates matching total population counts. Multivariate models were used to evaluate the role of a pain score in the reported use of opioids. Anchors for pain scores were 0 (no pain) and 10 (worst pain imaginable).
results31,355 observations were captured, which were extrapolated by the NHAMCS to represent 162,515,943 visits nationwide. Overall, patients with a score of 10 were 1.35 times more likely to receive an opioid than patients scoring a 9, 41.7% (CI95 39.7-43.8%) and 31.0% (CI95 28.8-33.3%), respectively. Opioid use was significantly different between traditional pain score cutoffs of mild (1-3) and moderate pain (4-6), where scores of 4 were 1.76 times more likely to receive an opioid than scores of 3, 15.5% (CI95 13.7-17.3%) and 8.8% (CI95 7.1-10.6%), respectively. Scores of 7 were 1.33 times more likely to receive opioids than scores of 6, 24.7% (CI95 23.0-26.3%) and 18.5% (CI95 16.9-20.0%), respectively. Fractures had the highest likelihood of receiving an opioid, as 49.2% of adolescents with a fracture received an opioid (CI95 46.4-51.9%). Within this subgroup, only adolescents reporting a fracture pain score of 10 had significantly higher opioid use than adjacent pain scores, where fracture patients scoring a 10 were 1.4 times more likely to use opioids than those scoring 9, 82.2% (CI95 76.1-88.4%) and 59.8% (CI95 49.0-70.5%), respectively.
conclusionsWhile some guidelines in the adult population have revised cut-offs and groupings of the traditional tiers on a 0-10 point pain scale, the adolescent population may also require further examination to potentially warrant a similar adjustment.
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