We sought quantify racial disparities in use of analgesia amongst patients seen in Emergency Departments for renal colic.
We identified all individuals presenting to the Emergency Department with urolithiasis from 2003 to 2015 in the nationally representative Premier Hospital Database. We included patients discharged in ≤1 day and excluded those with chronic pain or renal insufficiency. We assessed the relationship between race/ethnicity and opioid dosage in morphine milligram equivalents (MME), and ketorolac, through multivariable regression models adjusting for patient and hospital characteristics.
The cohort was 266,210 patients, comprised of White (84%), Black (6%) and Hispanic (10%) individuals. Median opioid dosage was 20 MME and 55.5% received ketorolac. Our adjusted model showed Whites had highest median MME (20 mg) with Blacks (-3.3 mg [95% CI: -4.6 mg to -2.1 mg]) and Hispanics (-6.0 mg [95% CI: -6.9 mg to -5.1 mg]) receiving less. Blacks were less likely to receive ketorolac (OR: 0.72, 95% CI: 0.62-0.84) while there was no difference between Whites and Hispanics.
Black and Hispanic patients in American Emergency Departments with acute renal colic receive less opioid medication than White patients; Black patients are also less likely to receive ketorolac.
The American journal of emergency medicine. 2020 Jan 08 [Epub ahead of print]
Alexandra Joice Berger, Ye Wang, Courtney Rowe, Benjamin Chung, Steven Chang, George Haleblian
Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Division of Pediatric Urology, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, CT, USA., Department of Urology, Stanford University Medical Center, Palo Alto, CA, USA., Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: .