{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:23:19Z","timestamp":1785338599146,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and importance<\/jats:title>\n            <jats:p>Suboptimal acute pain care has been previously reported to be associated with demographic characteristics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The aim of this study was to assess a healthcare system\u2019s multi-facility database of emergency attendances for abdominal pain, to assess for an association between demographics (age, sex, and ethnicity) and two endpoints: time delay to initial analgesia (primary endpoint) and selection of an opioid as the initial analgesic (secondary endpoint).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design, setting, and participants<\/jats:title>\n            <jats:p>This retrospective observational study assessed four consecutive months\u2019 visits by adults (\u226518\u2009years) with a chief complaint of abdominal pain, in a UK National Health Service Trust\u2019s emergency department (ED). Data collected included demographics, pain scores, and analgesia variables.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcome measures and analysis<\/jats:title>\n            <jats:p>Categorical data were described with proportions and binomial exact 95% confidence intervals (CIs). Continuous data were described using median (with 95% CIs) and interquartile range (IQR). Multivariable associations between demographics and endpoints were executed with quantile median regression (National Health Service primary endpoint) and logistic regression (secondary endpoint).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main results<\/jats:title>\n            <jats:p>In 4231 patients, 1457 (34.4%) receiving analgesia had a median time to initial analgesia of 110\u2005min (95% CI, 104\u2013120, IQR, 55\u2013229). The univariate assessment identified only one demographic variable, age decade (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001), associated with the time to initial analgesia. Association between age and time to initial analgesia persisted in multivariable analysis adjusting for initial pain score, facility type, and time of presentation; for each decade increase the time to initial analgesia was linearly prolonged by 6.9\u2005min (95% CI, 1.9\u201311.9; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.007). In univariable assessment, time to initial analgesia was not associated with either detailed ethnicity (14 categories, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.109) or four-category ethnicity (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.138); in multivariable analysis ethnicity remained non-significant as either 14-category (all ethnicities\u2019 <jats:italic toggle=\"yes\">P<\/jats:italic> \u2265 0.085) or four-category (all <jats:italic toggle=\"yes\">P<\/jats:italic> \u2265 0.138). No demographic or operational variables were associated with the secondary endpoint; opioid initial choice was associated only with pain score (<jats:italic toggle=\"yes\">P<\/jats:italic>= 0.003).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In a consecutive series of patients with abdominal pain, advancing age was the only demographic variable associated with prolonged time to initial analgesia. Older patients were found to have a linearly increasing, age-dependent risk for prolonged wait for pain care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/mej.0000000000001143","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T11:00:27Z","timestamp":1716807627000},"page":"332-338","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Older age and risk for delayed abdominal pain care in the emergency department"],"prefix":"10.1097","volume":"31","author":[{"given":"Ben","family":"Bloom","sequence":"first","affiliation":[{"name":"Blizard Institute for Neuroscience, Surgery, and Trauma, Barts and The London School of Medicine"},{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie L.","family":"Fritz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Pott","sequence":"additional","affiliation":[{"name":"Blizard Institute for Neuroscience, Surgery, and Trauma, Barts and The London School of Medicine"},{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imogen","family":"Skene","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raine","family":"Astin-Chamberlain","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Royal London Hospital and Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Immunology and Molecular Microbiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen H.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Blizard Institute for Neuroscience, Surgery, and Trauma, Barts and The London School of 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