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Research Letter
July 1, 2020

Pain Scores in Geriatric vs Nongeriatric Patients With Rib Fractures

Author Affiliations
  • 1Division of General Surgery, Department of Surgery, Stanford University, Stanford, California
  • 2Department of Epidemiology and Population Health, Stanford University, Stanford, California
  • 3School of Medicine, Stanford University, Stanford, California
  • 4Department of Surgery, St Joseph Health Medical Group, Santa Rosa, California
JAMA Surg. Published online July 1, 2020. doi:10.1001/jamasurg.2020.1933

Adequate pain control is the pillar of rib fracture management; patients must breathe comfortably to avoid pulmonary complications. Many rib fracture management decisions, such as escalating analgesic care, are grounded in improving patient-reported pain scores on the 10-point numerical rating scale (in which 0 indicates no pain and 10 the worst pain imaginable).1

Geriatric patients, who are known to have poorer outcomes after rib fractures compared with younger adults, have been shown to underreport pain.2-4 It is possible that geriatric patients with rib fractures underreport pain and may warrant a lower threshold to escalate analgesic care.

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