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primary topic: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment

Association between blood cortisol levels and numerical rating scale in prehospital pain assessment
type: AcademicArticle
type: Article
abstract: Background Nowadays, there is no correlation between levels of cortisol and pain in the prehospital setting. The aim of this work was to determine the ability of prehospital cortisol levels to correlate to pain. Cortisol levels were compared with those of the numerical rating scale (NRS). Methods This is a prospective observational study looking at adult patients with acute disease managed by Emergency Medical Services (EMS) and transferred to the emergency department of two tertiary care hospitals. Epidemiological variables, vital signs, and prehospital blood analysis data were collected. A total of 1516 patients were included, the median age was 67 years (IQR: 51–79; range: 18–103) with 42.7% of females. The primary outcome was pain evaluation by NRS, which was categorized as pain-free (0 points), mild (1–3), moderate (4–6), or severe (≥7). Analysis of variance, correlation, and classification capacity in the form area under the curve of the receiver operating characteristic (AUC) curve were used to prospectively evaluate the association of cortisol with NRS. Results The median NRS and cortisol level are 1 point (IQR: 0–4) and 282 nmol/L (IQR: 143–433). There are 584 pain-free patients (38.5%), 525 mild (34.6%), 244 moderate (16.1%), and 163 severe pain (10.8%). Cortisol levels in each NRS category result in p < 0.001. The correlation coefficient between the cortisol level and NRS is 0.87 (p < 0.001). The AUC of cortisol to classify patients into each NRS category is 0.882 (95% CI: 0.853–0.910), 0.496 (95% CI: 0.446–0.545), 0.837 (95% CI: 0.803–0.872), and 0.981 (95% CI: 0.970–0.991) for the pain-free, mild, moderate, and severe categories, respectively. Conclusions Cortisol levels show similar pain evaluation as NRS, with high-correlation for NRS pain categories, except for mild-pain. Therefore, cortisol evaluation via the EMS could provide information regarding pain status.
date: 2025-07
volume: 5
issue: 1
is part of: Communications Medicine
status: peerReviewed
status: published
author list: authors
type: EPrint
type: ArticleEPrint
is part of: repository
has document: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Texto)
has document: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Otro)
subject: Biomedicine

Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Texto)
type: Document
has file: s43856-025-01020-4.pdf
has part: s43856-025-01020-4.pdf

Communications Medicine
type: Collection
issn: 2730664X

Carlos del Pozo Vegas
type: Person
given name: Carlos
family name: del Pozo Vegas

Luis Alonso Dzul López
type: Person
given name: Luis Alonso
family name: Dzul López

Raúl López-Izquierdo
type: Person
given name: Raúl
family name: López-Izquierdo

Silvia Aparicio Obregón
type: Person
given name: Silvia
family name: Aparicio Obregón

Francisco Martín-Rodríguez
type: Person
given name: Francisco
family name: Martín-Rodríguez

Elisa A. Ingelmo-Astorga
type: Person
given name: Elisa A.
family name: Ingelmo-Astorga

Ancor Sanz-García
type: Person
given name: Ancor
family name: Sanz-García

Santos Gracia Villar
type: Person
given name: Santos
family name: Gracia Villar

Rubén Calderón Iglesias
type: Person
given name: Rubén
family name: Calderón Iglesias

Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Otro)
type: Document
is version of: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Texto)
is volatile version of: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Texto)
is index codes version of: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment (Texto)
has file: indexcodes.txt
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primary topic: Association between blood cortisol levels and numerical rating scale in prehospital pain assessment

Biomedicine
type: Concept
preferred label: Biomedicina @es