ArticleThe Journal of emergency medicine2026
Exploring Demographic Differences in Postintubation Analgesia by Racial Group, Sex, and Age.
Article in The Journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
backgroundAfter rapid sequence intubation (post-RSI), patients require analgesia to ensure adequate pain management; however, extant research suggests that in other medical procedures, there are demographic differences in analgesic prescribing.
objectivesWe examined potential sociodemographic differences in post-RSI opioid prescribing across a Med-Atlantic healthcare system. We hypothesized that Black (vs. White), female (vs. male), and older (vs. younger) patients would receive lower opioid doses post-RSI.
methodsWe conducted a retrospective chart review of all intubated adults (analytic n = 1211; 65.81% Black; 46.05% Female; Age Median = 61.00 [60.00, 63.00]) in 2019. We extracted demographics (sex, racial group, age), comorbidities, and opioid dose in Milligram Morphine Equivalent (MME). As only 29.4% of patients received an opioid, we tested our hypotheses with a zero-inflated Poisson model.
resultsIncreasing age was associated with a significantly lower likelihood of receiving an opioid (odds ratios [OR] = 0.81, p = 0.021) and lower MME doses when they received an opioid (rate ratio [RR] = 0.87, p < 0.001). Black (vs. White) patients had significantly higher odds of receiving an opioid (OR = 1.66, p = 0.010), but lower MME doses (RR = 0.71, p < 0.001). Sex did not significantly influence opioid prescribing likelihood, but if they received an opioid, female patients received lower MME than male patients (RR = 0.90, p = 0.018).
conclusionOur data revealed significant racialized, sex-, and age-based disparities and inequities in opioid prescribing postintubation. Future work is needed to examine best practices in age-related post-RSI opioid recommendations and establish standardized practices that promote equitable analgesia for all patients.
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