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עמוד בית
Sun, 21.07.24

ORIGINAL ARTICLES

IMAJ | volume 24

Journal 9, September 2022
pages: 612-618

Is Gender a Risk Factor for Oligoanalgesia in the Military Prehospital Trauma Setting?

1Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel Departments of 2Internal Medicine E and 3Dermatology, Sheba Medical Center, Tel Hashomer, Israel Divisions of 4Anesthesia, Intensive Care, and Pain Management and 5Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 6Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

Summary

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

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