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Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture: a multicenter exploratory study

Published online by Cambridge University Press:  27 August 2014

Margaret Fry ,
Glenn Arendts ,
Lynn Chenoweth  and
Casimir MacGregor
Margaret Fry*
Affiliation:
Research and Practice Development, Northern Sydney Local Health District, St Leonards, NSW, Australia School of Nursing, University of Sydney, Sydney, NSW, Australia
Glenn Arendts
Affiliation:
School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, WA, Australia
Lynn Chenoweth
Affiliation:
Aged and Extended Care Nursing, University of Technology, Sydney, NSW, Australia Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
Casimir MacGregor
Affiliation:
Research and Practice Development, Northern Sydney Local Health District, St Leonards, NSW, Australia
*
Correspondence should be addressed to: Professor Margaret Fry, Research and Practice Development, Nursing and Midwifery Directorate, Northern Sydney Local Health District, Level 7, Kolling Building, Royal North Shore Hospital, St Leonards, NSW 2065, Australia. Phone: +61-2-9926-4693. Email: margaret.fry@sydney.edu.au.
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Abstract

Background:

Older people who present to the emergency department (ED) often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture.

Methods:

The aim of the study was to determine if cognitive impairment is associated with a delayed analgesic response. A 12-month exploratory study, using patient data, was conducted across four EDs. Medical records of 264 patients with long bone fractures were randomly selected.

Results:

The majority of patients waited longer than 60 minutes for analgesia. The median time to analgesia was longer for the cognitively impaired (149 minutes) compared with cognitively intact (72 minutes; Mann–Whitney U test: p < 0.001).

Conclusions:

This study suggests that cognitive impairment is a significant risk factor for delayed analgesia response in the ED.

Keywords

analgesiapain managementgeriatricsemergency departmentsmusculoskeletal conditionsdementiamild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 2 , February 2015 , pp. 323 - 328
Copyright
Copyright © International Psychogeriatric Association 2014 

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