Time to Analgesia Provision for Abdominal Pain Presentations in the Emergency Department: The Effect of Biological Sex—A Retrospective Cohort Study

OBJECTIVE: Abdominal pain is a common emergency department (ED) presentation. Currently, there is limited Australian literature detailing whether biological sex results in differences in analgesia provision for abdominal pain. The primary aim of this study is to determine whether there is a difference in time to analgesia administration based on biological sex for patients presenting with abdominal pain to the ED. METHODS: This was a retrospective, single centre cohort study of adult patients presenting to the Royal Melbourne Hospital ED between April 1st and 30th 2024 with abdominal pain. Data relating to the patient's presentation and management were collected from records of eligible patients. RESULTS: Of 708 eligible patients, 292 (41%) were biologically male and 416 (59%) female. There were 559 (80%) patients who received at least one dose of analgesia. Females waited a median of 75 min and males 59 min to receive their first dose of analgesia (difference in medians = 16 min, 95% confidence interval [CI] 0.9-31.0 min, p = 0.04). Females were also nearly half as likely to receive parenteral analgesia (OR 0.56, 95% CI 0.38-0.82, p = 0.003). We found minimal differences in diagnoses, triage category or pain scores between sexes. CONCLUSION: Females presenting to the ED with abdominal pain are waiting longer than males to receive their first dose of analgesia and are less likely to receive parenteral analgesia. Further research is required to determine the reason for this discrepancy and to then remediate it.