Home Emergency Medicine Racial Disparities in Analgesia for Children With Appendicitis

Racial Disparities in Analgesia for Children With Appendicitis

Black children less likely to receive pain meds for moderate pain, less likely to receive opioids

TUESDAY, Sept. 14, 2015 (HealthDay News) — For pediatric patients with appendicitis, racial disparities exist with respect to analgesia administration, according to a study published online Sept. 14 in JAMA Pediatrics.

Monika K. Goyal, M.D., from the Children’s National Health System in Washington, D.C., and colleagues examined racial differences in analgesia administration among children diagnosed as having appendicitis. The frequency of both opioid and nonopioid analgesia administration was calculated in a cross-sectional study of patients aged 21 years or younger evaluated in the emergency department with a diagnosis of appendicitis.

The researchers identified 0.94 million children who were diagnosed with appendicitis. Overall, 56.8 percent received analgesia of any type, with 41.3 percent receiving opioid analgesia (20.7 and 43.1 percent of black and white patients, respectively). Compared with white patients, black patients with moderate pain were less likely to receive any analgesia (adjusted odds ratio, 0.1) when stratified by pain score and adjusted for ethnicity. Among children with severe pain, black patients were also less likely than white patients to receive opioids (adjusted odds ratio, 0.2). No significant differences were seen in the overall rate of analgesia administration by race in a multivariable model; however, opioid analgesia was received significantly less frequently by black versus white patients (adjusted odds ratio, 0.2).

“Appendicitis pain is undertreated in pediatrics, and racial disparities with respect to analgesia administration exist,” the authors write.

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