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Association Between Inadequate Pain Control and Emergency Department Utilization in Trauma Patients.

Sophia M Smith¹, Rachel Adams², Emily J Ha³

¹Boston Medical Center, Department of Surgery, Boston, Massachusetts; Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.

The Journal of Surgical Research

|May 29, 2025

Summary

This summary is machine-generated.

Trauma patients discharged without opioids had higher emergency department (ED) visits for pain. Prescribing opioids at discharge may reduce revisits, but the quantity prescribed was not significant for pain control.

Keywords:

Emergency department Opioids Pain management Trauma

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Area of Science:

Traumatology
Pain Management
Health Services Research

Background:

Up to 20% of trauma patients revisit the emergency department (ED) within 30 days, often for pain.
The relationship between inpatient opioid use, discharge prescriptions, and subsequent ED visits for pain is not well understood.

Purpose of the Study:

To investigate the association between opioid discharge prescriptions and emergency department (ED) visits for pain in trauma patients.
To determine if the quantity of prescribed opioids at discharge influences ED revisits for uncontrolled pain.

Main Methods:

Retrospective, case-control study of adult trauma patients requiring opioids at discharge.
Analysis of data from 2018-2021 at an urban level I trauma center.
Multivariable logistic regression to assess the impact of discharge opioid prescriptions and prescribed pain control duration on ED visits for pain.

Main Results:

74.76% of patients received opioid discharge prescriptions; 10.64% had an ED visit for pain.
Patients discharged with opioids had significantly lower odds of ED visits for pain (OR 0.66, P=0.04).
Prescribed days of pain control at discharge were not significantly associated with reduced ED visits for uncontrolled pain (OR 0.96, P=0.19).

Conclusions:

Lack of opioid discharge prescriptions is linked to increased ED visits for pain among trauma patients requiring opioids.
For patients prescribed opioids, the quantity did not significantly impact ED revisits, suggesting a conservative prescribing approach may be suitable.
Optimizing pain management and potentially reducing ED revisits requires careful inpatient pain control, appropriate tapering, and commensurate discharge prescriptions.