Evidence map›Paper›PMID 35132589›Full record

ArticleCJEM2022

An evaluation of emergency pain management practices in fragility fractures of the pelvis.

Uyen Evelyn Tran, Krishan Yadav, Mohamed Mohamed Ali, Michael Austin, Marie-Joe Nemnom, Debra Eagles

Abstract read
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In one paragraph

Article in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 15% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Observational
  4. Article
  5. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Uyen Evelyn TranDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Krishan YadavDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Mohamed Mohamed AliWestern University, London, ON, Canada.
Michael AustinDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Marie-Joe NemnomClinical Epidemiology Program, Ottawa Hospital Research Institute, F658a, Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
Debra EaglesDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada. deagles@toh.ca.ORCID http://orcid.org/0000-0002-7454-2721
University of Ottawa · CAOttawa Hospital · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInadequately treated pain is associated with significant morbidity in older adults. We aimed to describe current pain management practices for patients with fragility pelvic fractures, a common emergency department (ED) presentation in older adults.

methodsWe performed a health records' review of adults ≥ 65 years old who presented to two academic EDs with nonoperative fragility pelvic fractures between 01/2014 and 09/2018. The primary outcome measures were type and timing of analgesic medications. Secondary outcome measures included ancillary service consultation, ED length of stay, admission rate and rate of return to ED at 30 days. Data were reported using descriptive statistics.

resultsWe included 411 patients. The majority were female (339, 82.5%) with mean age 83.9 (SD 8.1) years. Nearly, one-third (130, 31.6%) did not receive any analgesia for their fracture. Analgesia was initiated in 123 (29.9%) patients through paramedic and nursing medical directives; 244 (59.4%) patients received physician-initiated opioids (hydromorphone 228 (55.5%); morphine 28 (6.8%)). Only 23.1% of patients received one or more ancillary services: physiotherapy (10.5%), social work (7.3%), geriatric nurse assessment (14.1%), and homecare (3.9%). Mean ED length of stay was 11.6 (SD 7.1) h; 210 (51.1%) patients were admitted; of those discharged, 45 (22.4%) returned to the ED within 30 days.

conclusionOne in three older adults presenting to the ED with nonoperative fragility pelvic fractures receive no analgesia during the course of their prehospital and ED care. Barriers to quality care must be identified and processes implemented to ensure adequate pain management for this population.

Indexed as

Fractures, BonePain ManagementAgedAged, 80 and overAnalgesicsEmergency Service, HospitalFemaleHumansMalePainPelvisRetrospective StudiesAnalgesicsEmergency DepartmentFragility pelvic fractureOlderPain

Identifiers

PMID35132589
OpenAlexW4210284765

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Registered trials

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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.