Subjective risk factors of severe pain at discharge from the emergency department

To examine the risk factors for severe pain upon discharge from the emergency department, assuming appropriate pharmacological treatment of pain, in order to improve pain relief in emergency departments and reduce the risk of potential chronic pain.

An analytic study was conducted utilizing data from a multicenter randomized controlled trial to evaluate patients' experiences upon admission and discharge from the emergency department (ED). Severe pain was defined by a score of six on a numerical rating scale of zero to ten. Stress and negative emotions (including anger, fear, sadness, and regret) were evaluated using numerical rating scales, respectively ranging from 0 to 10 and 1 to 5. The risk factors of severe pain at discharge (SPD) from ED were calculated using logistic regression considering patient characteristics evaluated at their admission to the ED.

From the 1240 patients analyzed, 22.2% had SPD from the ED. Each increase of one point in the intensity of acute pain and anger was significantly associated with a higher risk of SPD from ED. In addition, woman, negative self-perceived health, and age under 65 years, are other significant factors associated with SPD from the ED.

In addition to acute pain on admission, this study highlights new factors to consider when managing pain in emergency care, such as anger, and self-perceived health. Addressing these aspects can help reduce the likelihood of developing SPD from the ED, which in turn could potentially lead to the onset of chronic pain in future.

SOFTER IV Project clinical identification number: NCT04916678.