Sex- and age-related patterns in the use of analgesics in older patients in the emergency department.

Autor:	Miró Ò; Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona., Osorio GI; Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona., Alquézar-Arbé A; Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Catalonia., Aguiló S; Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona., Fernández C; Emergency Department, Hospital Clínico San Carlos, IDISSC, Complutense University, Madrid., Burillo G; Emergency Department, Hospital Universitario de Canarias, University of La Laguna, Tenerife, Canary Islands., Jacob J; Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia., Montero-Pérez FJ; Emergency Department, Hospital Universitario Reina Sofía, Córdoba., García-Lamberechts EJ; Emergency Department, Hospital Clínico San Carlos, IDISSC, Complutense University, Madrid., Piñera P; Emergency Department, Hospital Universitario Reina Sofia, Murcia., Rodríguez Valles C; Emergency Department, Hospital del Nalón, Langreo, Asturias., Carrasco Fernández E; Emergency Department, Hospital Altagracia, Manzanares., Molina L; Emergency Department, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo., Ruescas E; Emergency Department, Hospital Universitario Vinalopó, Elche, Alicante., Fernández Salgado F; Emergency Department, Hospital de Móstoles, Madrid., Fernández-Simón Almela A; Emergency Department, Hospital Virgen del Rocio, Sevilla., de Juan Gómez MÁ; Emergency Department, Hospital General Universitario Dr. Peset, Valencia., Guiu Martí S; Emergency Department, Hospital Universitario Son Espases, Palma., López-Laguna N; Emergency Department, Clínica Universitaria Navarra, Madrid., García Acosta J; Emergency Department, Hospital Clínico Universitario De Valencia, Valencia., Maza Vera MT; Emergency Department, Hospital Álvaro Cunqueiro, Vigo, Pontevedra., García García Á; Emergency Department, Hospital Universitario De Salamanca, Salamanca., Ezponda P; Emergency Department, Hospital De Zumarraga, Gipuzkoa., Martínez Lorenzo A; Emergency Department, Hospital Virxe Da Xunqueira, Cee, A Coruña., Ortega Liarte JV; Servicio de Urgencias, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia., Sánchez Ramón S; Emergency Department, Hospital Universitario Río Ortega, Valladolid., Ruiz Ramos J; Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain., González Del Castillo J; Emergency Department, Hospital Clínico San Carlos, IDISSC, Complutense University, Madrid.
Jazyk:	angličtina
Zdroj:	European journal of emergency medicine : official journal of the European Society for Emergency Medicine [Eur J Emerg Med] 2024 Apr 01; Vol. 31 (2), pp. 108-117. Date of Electronic Publication: 2023 Oct 04.
DOI:	10.1097/MEJ.0000000000001096
Abstrakt:	Background: Treatment of acute pain in older patients is a common challenge faced in emergency departments (EDs). Despite many studies that have investigated chronic analgesic use in the elderly, data on patterns of acute use, especially in EDs, of analgesics according to patient characteristics is scarce. Objective: To investigate sex- and age-related patterns of analgesic use in the Spanish EDs and determine differences in age-related patterns according to patient sex. Design: A secondary analysis of the Emergency Department and Elderly Needs (EDEN) multipurpose cohort. Setting: Fifty-two Spanish EDs (17% of Spanish EDs covering 25% of Spanish population). Participants: All patients' ≥65 years attending ED during 1 week (April 1-7, 2019). Patient characteristics recorded included age, sex, chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and opiates, comorbidity, dependence, dementia, depression, ability to walk and previous falls. Analgesics used in the ED were categorized in three groups: non-NSAID non-opioids (mainly paracetamol and metamizole, PM), NSAIDs, and opiates. Outcome Measures: Frequency of analgesic use was quantified, and the relationship between sex and age and analgesic use (in general and for each analgesic group) was assessed by unadjusted and adjusted logistic regression and restricted cubic spline models. Interaction between sex and age was explored. Main Results: We included 24 573 patients, and 6678 (27.2%) received analgesics in the ED: 5551 (22.6%) PM, 1661 (6.8%) NSAIDs and 937 (3.8%) opiates (1312 received combinations). Analgesics were more frequently used in women (adjusted OR = 1.076, 95%CI = 1.014-1.142), as well as with NSAID (1.205, 1.083-1.341). Analgesic use increased with age, increasing PM and decreasing NSAIDs use. Opiate use remained quite constant across age and sex. Interaction of sex with age was present for the use of analgesics in general ( P  = 0.006), for PM ( P  < 0.001) and for opiates ( P  = 0.033), with higher use of all these analgesics in women. Conclusion: Use of analgesics in older individuals in EDs is mildly augmented in women and increases with age, with PM use increasing and NSAIDs decreasing with age. Conversely, opiate use is quite constant according to sex and age. Age-related patterns differ according to sex, with age-related curves of women showing higher probabilities than those of men to receive any analgesic, PM or opiates. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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