Abstract
Background
Age-related differences in pain perception have been demonstrated in experimental
settings but have been investigated scarcely and without valid scale in the clinical
framework.
Objectives
To examine the effect of age on pain perception for recognized painful diagnoses encountered
in the emergency department (ED).
Methods
A post-hoc analysis of real-time archived data was performed in a tertiary urban and
a secondary regional ED. We included all consecutive adult patients (≥18 years) with
the following diagnosis at discharge: renal colic, pancreatitis, appendicitis, headache/migraine,
dislocation and extremities fractures, and a pain evaluation of ≥1 (0−10, verbal numerical
scale) at triage. The primary outcome was to compare for each of these diagnoses the
level of pain intensity between four age groups (18−44; 45−64; 65−74; 75+ years).
Results
A total of 15,670 patients (48% women) were triaged with a mean pain intensity of
7.7 (SD=2.0). Women exhibited greater pain scores than men for pancreatitis, headache/migraine,
and extremity fracture. Renal colic, pancreatitis, appendicitis, and headache/migraine
showed a linear decrease in pain scores with age whereas dislocation and extremity
fractures did not present age differences. Mean differences in pain intensity scores
between young adults (18−44 years) and patients aged ≥75 years were 0.79 (95% confidence
interval [95% CI] 0.5−1.1) for renal colic, 1.1 (95% CI 0.7−1.4) for pancreatitis,
0.70 (95% CI 0.2−1.2) for appendicitis, and 0.86 (95% CI 0.6−1.1) for headache/migraine.
Conclusion
Older patients perceive similar pain for dislocation and extremity fractures and less
for visceral and headache/migraine pain; however, these age differences may not be
clinically important.
Keywords
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Article info
Publication history
Published online: September 23, 2015
Accepted:
June 25,
2015
Received in revised form:
June 16,
2015
Received:
January 16,
2015
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
