Race, ethnicity, and management of pain from long-bone fractures: A prospective study of two academic urban emergency departments

Polly E. Bijur, Anick Bérard, David Esses, Yvette Calderon, E. John Gallagher

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objectives: The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs). Methods: This was a prospective observational study of a convenience sample of patients with longbone fractures from April 2002 to November 2006 in two academic urban EDs. Eligibility criteria were age 18-55 years, isolated long-bone fracture, and race and ethnicity (Hispanic, African American, and white). The primary outcome was receipt of analgesics; secondary outcomes included receipt of opioids, dose, route, time to first analgesic, and change in pain. Logistic regression was used to adjust the risk of receiving analgesics for patients' initial rating of pain and demographic characteristics. Results: Of 1,239 patients with suspected long-bone fractures, 345 patients were eligible: 177 (51%) were Hispanic, 98 (28%) were African American, and 70 (20%) were white. Administration of analgesics was not associated with race or ethnicity. Sixteen percent (95% confidence interval [CI] = 11% to 22%) of Hispanic, 15% (95% CI = 10% to 24%) of African American, and 14% (95% CI = 8% to 24%) of white patients did not receive any analgesics. Seventy-four percent of Hispanic (95% CI = 67% to 80%), 66% of African American (95% CI = 57% to 75%), and 69% (95% CI = 57% to 78%) of white patients received opioid analgesics. After adjustment for covariates, there was no evidence of an association between receipt of analgesics or opioid analgesics and the race or ethnicity of the patients. There were no significant differences in time to treatment, dose, route, or change in pain. Conclusions: Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.

Original languageEnglish (US)
Pages (from-to)589-597
Number of pages9
JournalAcademic Emergency Medicine
Volume15
Issue number7
DOIs
StatePublished - Jul 2008

Fingerprint

Bone Fractures
Pain Management
Hospital Emergency Service
Prospective Studies
Analgesics
Hispanic Americans
African Americans
Confidence Intervals
Opioid Analgesics
Pain
Observational Studies
Logistic Models
Demography

Keywords

  • African American
  • Analgesia
  • Disparities
  • Fractures
  • Hispanic
  • Opioid analgesia

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

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title = "Race, ethnicity, and management of pain from long-bone fractures: A prospective study of two academic urban emergency departments",
abstract = "Objectives: The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs). Methods: This was a prospective observational study of a convenience sample of patients with longbone fractures from April 2002 to November 2006 in two academic urban EDs. Eligibility criteria were age 18-55 years, isolated long-bone fracture, and race and ethnicity (Hispanic, African American, and white). The primary outcome was receipt of analgesics; secondary outcomes included receipt of opioids, dose, route, time to first analgesic, and change in pain. Logistic regression was used to adjust the risk of receiving analgesics for patients' initial rating of pain and demographic characteristics. Results: Of 1,239 patients with suspected long-bone fractures, 345 patients were eligible: 177 (51{\%}) were Hispanic, 98 (28{\%}) were African American, and 70 (20{\%}) were white. Administration of analgesics was not associated with race or ethnicity. Sixteen percent (95{\%} confidence interval [CI] = 11{\%} to 22{\%}) of Hispanic, 15{\%} (95{\%} CI = 10{\%} to 24{\%}) of African American, and 14{\%} (95{\%} CI = 8{\%} to 24{\%}) of white patients did not receive any analgesics. Seventy-four percent of Hispanic (95{\%} CI = 67{\%} to 80{\%}), 66{\%} of African American (95{\%} CI = 57{\%} to 75{\%}), and 69{\%} (95{\%} CI = 57{\%} to 78{\%}) of white patients received opioid analgesics. After adjustment for covariates, there was no evidence of an association between receipt of analgesics or opioid analgesics and the race or ethnicity of the patients. There were no significant differences in time to treatment, dose, route, or change in pain. Conclusions: Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.",
keywords = "African American, Analgesia, Disparities, Fractures, Hispanic, Opioid analgesia",
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T1 - Race, ethnicity, and management of pain from long-bone fractures

T2 - A prospective study of two academic urban emergency departments

AU - Bijur, Polly E.

AU - Bérard, Anick

AU - Esses, David

AU - Calderon, Yvette

AU - Gallagher, E. John

PY - 2008/7

Y1 - 2008/7

N2 - Objectives: The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs). Methods: This was a prospective observational study of a convenience sample of patients with longbone fractures from April 2002 to November 2006 in two academic urban EDs. Eligibility criteria were age 18-55 years, isolated long-bone fracture, and race and ethnicity (Hispanic, African American, and white). The primary outcome was receipt of analgesics; secondary outcomes included receipt of opioids, dose, route, time to first analgesic, and change in pain. Logistic regression was used to adjust the risk of receiving analgesics for patients' initial rating of pain and demographic characteristics. Results: Of 1,239 patients with suspected long-bone fractures, 345 patients were eligible: 177 (51%) were Hispanic, 98 (28%) were African American, and 70 (20%) were white. Administration of analgesics was not associated with race or ethnicity. Sixteen percent (95% confidence interval [CI] = 11% to 22%) of Hispanic, 15% (95% CI = 10% to 24%) of African American, and 14% (95% CI = 8% to 24%) of white patients did not receive any analgesics. Seventy-four percent of Hispanic (95% CI = 67% to 80%), 66% of African American (95% CI = 57% to 75%), and 69% (95% CI = 57% to 78%) of white patients received opioid analgesics. After adjustment for covariates, there was no evidence of an association between receipt of analgesics or opioid analgesics and the race or ethnicity of the patients. There were no significant differences in time to treatment, dose, route, or change in pain. Conclusions: Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.

AB - Objectives: The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs). Methods: This was a prospective observational study of a convenience sample of patients with longbone fractures from April 2002 to November 2006 in two academic urban EDs. Eligibility criteria were age 18-55 years, isolated long-bone fracture, and race and ethnicity (Hispanic, African American, and white). The primary outcome was receipt of analgesics; secondary outcomes included receipt of opioids, dose, route, time to first analgesic, and change in pain. Logistic regression was used to adjust the risk of receiving analgesics for patients' initial rating of pain and demographic characteristics. Results: Of 1,239 patients with suspected long-bone fractures, 345 patients were eligible: 177 (51%) were Hispanic, 98 (28%) were African American, and 70 (20%) were white. Administration of analgesics was not associated with race or ethnicity. Sixteen percent (95% confidence interval [CI] = 11% to 22%) of Hispanic, 15% (95% CI = 10% to 24%) of African American, and 14% (95% CI = 8% to 24%) of white patients did not receive any analgesics. Seventy-four percent of Hispanic (95% CI = 67% to 80%), 66% of African American (95% CI = 57% to 75%), and 69% (95% CI = 57% to 78%) of white patients received opioid analgesics. After adjustment for covariates, there was no evidence of an association between receipt of analgesics or opioid analgesics and the race or ethnicity of the patients. There were no significant differences in time to treatment, dose, route, or change in pain. Conclusions: Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.

KW - African American

KW - Analgesia

KW - Disparities

KW - Fractures

KW - Hispanic

KW - Opioid analgesia

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