Abstract
Purpose
Initial pain level in the acute whiplash injury is the most consistent predictor of transformation to a chronic pain syndrome. The risk factors for those early pain levels were, to our knowledge, scarcely evaluate to this date. We set to evaluate whether gender, age or ethnicity comprise a risk factor for those initial pain levels. Further, gender, age and ethnicity have been shown to be bias factors in pain management. We investigated if gender, age or ethnicity are bias factor in pain management in the face of a standardized pain treatment protocol in the acute whiplash injury.
Methods
We reviewed 2,538 patients with acute whiplash injury that were treated at our emergency department (ED). Gender, age and ethnicity were investigated as risk factors for elevated visual analog scale (VAS) scores. Those factors were also investigated as bias in pain medication administration in the face of a standardized analgesic protocol.
Results
Women had significantly higher VAS scores (p = 0.009). Age and ethnicity did not influence pain levels. There was no influence of gender or age on pain medication administration. The Jewish patients (the majority in Israel) were administered fewer pain medication (p < 0.0001).
Conclusion
Women have higher initial pain levels in the acute whiplash injury. Age and ethnicity have less impact on those pain levels. A pain management protocol might reduce bias in pain management in the acute whiplash injury in the ED. The Jewish population tends to be less receptive to pain medication administration.
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Acknowledgments
The authors thank Mrs. Ronit Leiba for statistical analysis of the manuscript.
Conflict of interest
Lior Koren, Eli Peled, Revital Trogan, Doron Norman, Yaron Berkovich and Shlomo Israelit declare that they have no conflict of interest.
Ethical standard
The study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The manuscript does not contain clinical studies or patient data.
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Koren, L., Peled, E., Trogan, R. et al. Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury. Eur J Trauma Emerg Surg 41, 287–291 (2015). https://doi.org/10.1007/s00068-014-0419-2
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DOI: https://doi.org/10.1007/s00068-014-0419-2