Association between English proficiency and timing of analgesia administration after surgery

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Pediatric Hospital. October 15, 2021: hpeds.2020-005766. doi: 10.1542 / hpeds.2020-005766. Online ahead of print.


BACKGROUND: Pediatric patients from families with limited English proficiency (LEP) are at risk for health care disparities. We examined the timeliness of analgesic administration in postoperative pediatric patients with limb fracture in LEP families compared to non-LEP families.

METHODS: This was a retrospective cohort study of children aged 1 year to less than 18 years, hospitalized in the general floor of patients hospitalized after surgical correction of fractures of a single limb between July 2016 and July 2019 were eligible. Patients whose consent was in a language other than English or for whom an interpreter was used were classified as from LEP families. The primary outcome measure was the time to first analgesia. Secondary outcomes included time to first opioid, proportion of analgesics and opioid analgesics, and number of pain assessments. Associations between LEP and results were tested using χ2 tests, Kaplan-Meier plots and Cox proportional hazards models.

RESULTS: We examined 306 patients, of which 59 (19%) belonged to LEP families. Children in LEP families were significantly less likely to receive analgesia (86.4% vs. 96.8%, P ≤ 0.01) and experienced a longer time to first analgesia in the unadjusted (hazard ratio = 0.68, 95% confidence interval: 0.50-0.92) and adjusted analyzes (risk ratio = 0.68) and risk = 0.68, 95% confidence interval: 0.50 to 0.94). There was no significant association between SARA and time to first opioid, proportion of opioid analgesics, or number of pain assessments.

Conclusion: Hospitalized children from LEP families experience a longer delay before administration of analgesia after surgery. The mechanisms that lead to these differences in care need to be identified so that interventions can be designed to address them.

PMID:34654728 | DO I:10.1542 / hpeds.2020-005766

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