Pain Scales in the ED: Can They Predict Admission for Abdominal Pain?

Persistent Link:
http://hdl.handle.net/10150/281194
Title:
Pain Scales in the ED: Can They Predict Admission for Abdominal Pain?
Author:
Johnson, Annelyssa
Affiliation:
The University of Arizona College of Medicine - Phoenix
Issue Date:
Mar-2013
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Collection Information:
This item is part of the College of Medicine - Phoenix Scholarly Projects 2013 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.
Publisher:
The University of Arizona.
Abstract:
OBJECTIVES and HYPOTHESIS: The purpose of this project was to assess whether pain scales have an association with the disposition of adult emergency department patients with abdominal pain. It is hypothesized that higher pain scores are associated with a greater likelihood of admission. METHODS: One hundred forty-nine patients (63 admitted and 86 discharged) 18 years and older who were evaluated for abdominal pain in the emergency department (ED) at Maricopa Medical Center were identified retrospectively through a case-control chart review. Demographic variables were compared to assess pain in different groups. Receiver operating characteristics curves (ROC) were created for initial, final, and change in pain scores. Logistic regression was performed to assess the interaction of the prespecified variables initial pain, presence of comorbidities, duration of pain, patient temperature, white blood cell count, and age. RESULTS: In an unadjusted analysis, patients with a higher initial pain score were admitted more often. There was no difference in final or change in pain score and disposition. Men had higher initial pain scores but women were more often admitted. No difference was found between races in pain scores. Patients with surgical diagnoses were admitted more often, and those with nonspecific or OB/GYN-related diagnoses were more often discharged. Patients were less likely to be admitted if imaging was not done. In an adjusted analysis, age was the only variable associated with an increased chance of admission, with an odds ratio of 1.048 (95% confidence interval 1.016-1.082) for each one-year increase. The initial pain score was not associated with admission in the adjusted analysis (odds ratio 1.095 (95% confidence interval 0.943-1.272)).
MeSH Subjects:
Pain Measurement; Abdominal Pain; Emergency Service, Hospital
Description:
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Mentor:
Sarko, John, MD; Smith, Ed, MD

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titlePain Scales in the ED: Can They Predict Admission for Abdominal Pain?en_US
dc.contributor.authorJohnson, Annelyssaen_US
dc.contributor.departmentThe University of Arizona College of Medicine - Phoenixen_US
dc.date.issued2013-03-
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.collectioninformationThis item is part of the College of Medicine - Phoenix Scholarly Projects 2013 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.en_US
dc.publisherThe University of Arizona.en_US
dc.description.abstractOBJECTIVES and HYPOTHESIS: The purpose of this project was to assess whether pain scales have an association with the disposition of adult emergency department patients with abdominal pain. It is hypothesized that higher pain scores are associated with a greater likelihood of admission. METHODS: One hundred forty-nine patients (63 admitted and 86 discharged) 18 years and older who were evaluated for abdominal pain in the emergency department (ED) at Maricopa Medical Center were identified retrospectively through a case-control chart review. Demographic variables were compared to assess pain in different groups. Receiver operating characteristics curves (ROC) were created for initial, final, and change in pain scores. Logistic regression was performed to assess the interaction of the prespecified variables initial pain, presence of comorbidities, duration of pain, patient temperature, white blood cell count, and age. RESULTS: In an unadjusted analysis, patients with a higher initial pain score were admitted more often. There was no difference in final or change in pain score and disposition. Men had higher initial pain scores but women were more often admitted. No difference was found between races in pain scores. Patients with surgical diagnoses were admitted more often, and those with nonspecific or OB/GYN-related diagnoses were more often discharged. Patients were less likely to be admitted if imaging was not done. In an adjusted analysis, age was the only variable associated with an increased chance of admission, with an odds ratio of 1.048 (95% confidence interval 1.016-1.082) for each one-year increase. The initial pain score was not associated with admission in the adjusted analysis (odds ratio 1.095 (95% confidence interval 0.943-1.272)).en_US
dc.typeThesisen_US
dc.subject.meshPain Measurementen_US
dc.subject.meshAbdominal Painen_US
dc.subject.meshEmergency Service, Hospitalen_US
dc.descriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.en_US
dc.contributor.mentorSarko, John, MDen_US
dc.contributor.mentorSmith, Ed, MDen_US
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