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Factors associated to unrelieved pain in a Morrocan Emergency Department

BACKGROUND: In the light of the impact that pain has on patients, emergency department (ED) physicians need to be well versed in its management, particularly in its acute presentation. The goal of the present study was to evaluate the prevalence of unrelieved acute pain during ED stay in a Moroccan...

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Autores principales: louriz, Maha, Belayachi, Jihane, Armel, Bouchra, Dendane, Tarek, Abidi, Khalid, Madani, Naoufel, Zekraoui, Aicha, Benchekroun, Abdellatif Belabes, Zeggwagh, Amine Ali, Abouqal, Redouane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233084/
https://www.ncbi.nlm.nih.gov/pubmed/25400695
http://dx.doi.org/10.1186/1755-7682-7-48
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author louriz, Maha
Belayachi, Jihane
Armel, Bouchra
Dendane, Tarek
Abidi, Khalid
Madani, Naoufel
Zekraoui, Aicha
Benchekroun, Abdellatif Belabes
Zeggwagh, Amine Ali
Abouqal, Redouane
author_facet louriz, Maha
Belayachi, Jihane
Armel, Bouchra
Dendane, Tarek
Abidi, Khalid
Madani, Naoufel
Zekraoui, Aicha
Benchekroun, Abdellatif Belabes
Zeggwagh, Amine Ali
Abouqal, Redouane
author_sort louriz, Maha
collection PubMed
description BACKGROUND: In the light of the impact that pain has on patients, emergency department (ED) physicians need to be well versed in its management, particularly in its acute presentation. The goal of the present study was to evaluate the prevalence of unrelieved acute pain during ED stay in a Moroccan ED, and to identify risk factors of unrelieved pain. METHODS: Prospective survey of patients admitted to the emergency department of Ibn Sina teaching university hospital in Rabat (Morocco). All patients with acute pain over a period of 10 days, 24 hours each day were included. From each patient, demographic and clinical data, pain characteristics, information concerning pain management, outcomes, and length of stay were collected. Pain intensity was evaluated both on arrival and before discharge using Numerical Rating Scale (NRS). Comparison between patient with relieved and unrelieved pain, and factors associated with unrelieved pain were analyzed using stepwise forward logistic regression. RESULTS: Among 305 patients who complained of acute pain, we found high levels of intense to severe pain at ED arrival (91.1%). Pain intensity decreased at discharge (46.9%). Unrelieved pain was assessed in 24.3% of cases. Patients with unrelieved pain were frequently accompanied (82.4% vs 67.1%, p = 0.012), and more admitted daily than night (8 am-20 pm: 78.4% vs 64.9%; 21 pm-7 am: 21.6% vs 35.1%, p = 0.031), and complained chiefly of pain less requently (56.8% vs 78.8%, p<0.001). They had progressive pain (73% vs 44.2%, p<0.001), and had a longer duration of pain before ED arrival (72-168 h: 36.5% vs 16.9%; >168 h: 25.5% vs 17.7%, p<0.001). In multivariate analysis, predictor factors of unrelieved pain were: accompanied patients (OR = 2.72, 95% CI = 1.28- 5.76, p = 0.009), pain as chief complaint (OR = 2.32, 95% CI = 1,25-4.31, p = 0.007), cephalic site of pain (OR = 6.28, 95% CI = 2.26-17.46, p<0.001), duration of pain before admission more than 72 hours (72-168 h (OR = 7.85, 95% CI = 3.13-25.30, p = 0.001), and >168 h (OR = 4.55, 95% CI = 1.77-14.90, p = 0.02). CONCLUSION: This study reported high levels of intense to severe pain at ED arrival. However, one quarter patients felt on discharge from the ED that their pain had not been relieved. The relief of pain in ED depend both sociodemographic, clinical, and pain characteristics factors.
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spelling pubmed-42330842014-11-17 Factors associated to unrelieved pain in a Morrocan Emergency Department louriz, Maha Belayachi, Jihane Armel, Bouchra Dendane, Tarek Abidi, Khalid Madani, Naoufel Zekraoui, Aicha Benchekroun, Abdellatif Belabes Zeggwagh, Amine Ali Abouqal, Redouane Int Arch Med Original Research BACKGROUND: In the light of the impact that pain has on patients, emergency department (ED) physicians need to be well versed in its management, particularly in its acute presentation. The goal of the present study was to evaluate the prevalence of unrelieved acute pain during ED stay in a Moroccan ED, and to identify risk factors of unrelieved pain. METHODS: Prospective survey of patients admitted to the emergency department of Ibn Sina teaching university hospital in Rabat (Morocco). All patients with acute pain over a period of 10 days, 24 hours each day were included. From each patient, demographic and clinical data, pain characteristics, information concerning pain management, outcomes, and length of stay were collected. Pain intensity was evaluated both on arrival and before discharge using Numerical Rating Scale (NRS). Comparison between patient with relieved and unrelieved pain, and factors associated with unrelieved pain were analyzed using stepwise forward logistic regression. RESULTS: Among 305 patients who complained of acute pain, we found high levels of intense to severe pain at ED arrival (91.1%). Pain intensity decreased at discharge (46.9%). Unrelieved pain was assessed in 24.3% of cases. Patients with unrelieved pain were frequently accompanied (82.4% vs 67.1%, p = 0.012), and more admitted daily than night (8 am-20 pm: 78.4% vs 64.9%; 21 pm-7 am: 21.6% vs 35.1%, p = 0.031), and complained chiefly of pain less requently (56.8% vs 78.8%, p<0.001). They had progressive pain (73% vs 44.2%, p<0.001), and had a longer duration of pain before ED arrival (72-168 h: 36.5% vs 16.9%; >168 h: 25.5% vs 17.7%, p<0.001). In multivariate analysis, predictor factors of unrelieved pain were: accompanied patients (OR = 2.72, 95% CI = 1.28- 5.76, p = 0.009), pain as chief complaint (OR = 2.32, 95% CI = 1,25-4.31, p = 0.007), cephalic site of pain (OR = 6.28, 95% CI = 2.26-17.46, p<0.001), duration of pain before admission more than 72 hours (72-168 h (OR = 7.85, 95% CI = 3.13-25.30, p = 0.001), and >168 h (OR = 4.55, 95% CI = 1.77-14.90, p = 0.02). CONCLUSION: This study reported high levels of intense to severe pain at ED arrival. However, one quarter patients felt on discharge from the ED that their pain had not been relieved. The relief of pain in ED depend both sociodemographic, clinical, and pain characteristics factors. BioMed Central 2014-11-08 /pmc/articles/PMC4233084/ /pubmed/25400695 http://dx.doi.org/10.1186/1755-7682-7-48 Text en © louriz et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
louriz, Maha
Belayachi, Jihane
Armel, Bouchra
Dendane, Tarek
Abidi, Khalid
Madani, Naoufel
Zekraoui, Aicha
Benchekroun, Abdellatif Belabes
Zeggwagh, Amine Ali
Abouqal, Redouane
Factors associated to unrelieved pain in a Morrocan Emergency Department
title Factors associated to unrelieved pain in a Morrocan Emergency Department
title_full Factors associated to unrelieved pain in a Morrocan Emergency Department
title_fullStr Factors associated to unrelieved pain in a Morrocan Emergency Department
title_full_unstemmed Factors associated to unrelieved pain in a Morrocan Emergency Department
title_short Factors associated to unrelieved pain in a Morrocan Emergency Department
title_sort factors associated to unrelieved pain in a morrocan emergency department
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233084/
https://www.ncbi.nlm.nih.gov/pubmed/25400695
http://dx.doi.org/10.1186/1755-7682-7-48
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