An evaluation of the association between patient sociodemographic factors and delayed time to analgesia in the trauma bay.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 41644342.
- Also identified by DOI 10.1016/j.injury.2026.113065.
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Abstract
Early and adequate analgesia is a critical component of injury care. While sociodemographic factors have been shown to impact the adequacy of analgesia in a variety of clinical settings, these relationships are poorly understood in trauma care. Our objective was to evaluate the association between patient and provider characteristics and time to analgesia during trauma resuscitation. We performed a retrospective cohort study of adult (age ≥ 16) patients presenting as trauma activations at a level I trauma center over 2 years (2019-2020). Data were derived from the institutional trauma registry and chart review. Time from presentation to first administration of analgesia was recorded. The primary outcome was delayed analgesia, defined as analgesia administered later than the 75th percentile of time to analgesia for all patients. Multivariable logistic regression was used to evaluate the effect of age, sex, and socioeconomic status on analgesia timing. Among 2497 patients meeting inclusion criteria (mean age 44.8 years [SD 21.6], 25.7% female), 1957 (77.5%) received analgesia in the trauma bay. Among patients who received analgesia in the trauma bay, median time to analgesia was 9 min (IQR 7-14). The only sociodemographic characteristic independently associated with delayed analgesia was age. Relative to patients aged 16-54, those aged 55-64 were 1.5-fold more likely to receive delayed analgesia (OR 1.46; 95% CI 1.05-2.03), while those aged ≥ 65 were twice as likely to have delayed analgesia (OR 2.16; 95% CI 1.58-2.95). Irrespective of age or injury severity, patients injured in falls were more likely to experience delayed analgesia (OR 1.64; 95% CI 1.20-2.23). Older adults and patients injured in a fall are more likely to experience delays in receiving analgesia. Strategies that ensure equity in pain management are needed such that all patients have equitable access to early and adequate pain control after injury.