Authors: Ahmad Mahmoud Wazzan , Moudi Alasmari , Yaser Rambo , Abdullah Murshid , Nawaf Alharthy , Abdulrahman Qurunfulah , Abdulellah Alqudsi

Abstract

Objective: This study aimed to evaluate the pain management practices for oncology patients in the emergency department (ED), focusing on pain assessment, analgesic use, and treatment effectiveness.
Methods: This retrospective cohort study was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia, from January 2020 to December 2023. A total of 341 oncology patients who presented to the ED with pain were included. As pain scores for most patients were missing, observed values were retained, and a transparent, conservative approach was used to estimate missing scores to enable inferential analyses. The primary outcome was effective pain relief (≥2-point reduction, 0–10 scale).
Results: The mean age was 54 years, and 47% of participants were male. Pre-treatment pain scores were documented in 18% of patients; reassessment after analgesia was recorded in 28%. The mean pain score decreased from 7.4 pre-treatment to 1.6 post-treatment (p < 0.001). Opioid use was associated with greater odds of effective relief compared with non-opioid regimens (adjusted OR = 2.0; 95% CI:1.3-3.0; p-value = 0.01).  
Conclusion: Analgesic treatment reduced pain, but low rates of baseline documentation and reassessment revealed critical process gaps. It is recommended to maintain triage pain scoring, nurse-driven reassessment, and education on multimodal analgesia and safe opioid titration.

Keywords: Cancer pain, emergency department, pain management, pain assessment, Saudi Arabia.