Is Gender a Risk Factor for Oligoanalgesia in the Military Prehospital Trauma Setting?
THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2022;
24:612-618. [PMID:
36168182]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND
Pain management is fundamental in the treatment of a trauma casualty. Adequate pain management is associated with decreased long-term morbidity and chronic pain. Nonetheless, pain is frequently not documented nor adequately treated in the prehospital setting, a phenomenon described as oligoanalgesia. Gender bias has been suggested as a risk factor for oligoanalgesia.
OBJECTIVES
To examine the association between casualty gender and pain management in the prehospital trauma setting.
METHODS
We conducted a retrospective cohort study of the Israel Defense Forces Trauma Registry between 2015 and 2020. Univariable analysis followed by multivariable logistic regression was used to assess the association between casualty gender and pain management. For adult patients for whom gender was known, pain scores were documented.
RESULTS
A total of 1044 casualties were included in the study; 894 (85.6%) were male. Females and males differed in several demographic and injury characteristics, including age in years (mean 36 vs. 27.6, P value < 0.001) and injury mechanism (16%% vs. 34.5% penetrating injury, P value < 0.001). Female casualties were less likely to be treated for pain (odds ratio [OR] 0.708, 95% confidence interval [95%CI] 0.5-1, P = 0.05). However, after adjustment for various factors, including pain severity, this association was insignificant (OR 0.748, 95%CI 0.46-1.23, P = 0.25).
CONCLUSIONS
In this prehospital study, gender bias in pain management was not apparent. As women's role on the battlefield continues to increase, further studies regarding the role of gender bias in casualty care are warranted.
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