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

Int Psychogeriatr. 2015 Feb;27(2):323-328. doi: 10.1017/S1041610214001732.

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: analgesia; dementia; emergency departments; geriatrics; mild cognitive impairment; musculoskeletal conditions; pain management.