Pain scores among emergency department (ED) patients: comparison by ED diagnosis

Treatment for pain and pain-related conditions has been identified as the most common reason for Emergency Department (ED) visits.

This study was undertaken to characterize the distribution of self-reported pain scores for common ED diagnoses.

In this retrospective exploratory chart review, eligible participants included all adult ED patients age 18 years and over, with a self-reported triage pain score of 1 or higher during January-June 2011. Data were collected from ED electronic medical records.

Among 1229 patients, the mean age was 44 years; 56% of patients were female, and 59% were white. The mean triage pain score for all patients was 7.1 (interquartile range 6-9). The most common reported diagnoses included: minor injuries (10%), abdominal pain (8%), and respiratory infections (8%). The diagnoses with the highest mean pain scores were: sickle cell crisis (mean pain score 8.7), back/neck/shoulder pain (8.5), and headache/migraine (8.3). Higher pain scores were significantly correlated with younger age (p<0.001) and number of ED visits (p<0.001). Demographic factors including female gender, African American race, and Medicaid insurance reported significantly higher pain scores (p<0.001). Patients with multiple ED visits in the recent 12 months reported significantly higher pain scores (p<0.001).

ED patients report a wide variety of pain scores. Factors associated with higher pain scores included younger age, female gender, African American race, Medicaid insurance status, multiple ED visits in the past year, and ED diagnoses of sickle cell crisis, back/neck/shoulder pain, and headache.