Clinical Analysis of Patients With Low Back Pain in the Emergency Department

Abstract

Objective To describe the daily practice in an emergency service and to provide relevant data for future studies about the treatment of low back pain from the perspective of emergency medicine. Methods Analysis of hospital records and review of medical records. Results 2,434 patients were attended between January 1 and December 31, 2017 with the complaint of low back pain. Radiographs of the spine were performed in 15.7% of patients and computerized tomography scans in 7.6%. Eighty-five patients required hospitalization, with a mean hospital stay of 8.3 days. The rate of use was 52.7% for tricyclic or antiepileptic drugs and 12% for strong opioids among hospitalized patients. Conclusions A high prevalence of low back complaints was observed in the emergency care service (4.6% of total emergency room visits during the year), with low hospitalization potential. The rates of hospitalization and tomographic examinations were higher than those observed in similar studies, with a lower proportion of radiograph and strong opioid use as compared with the same studies. The paucity of national and international data for more in-depth comparisons makes clear the need for further studies and development of new recommendations specifically targeting this subset of patients. Level of evidence IV; Prognostic studies.

Global prevalence of hospital admissions for low back pain: a systematic review with meta-analysis

“…Similarly, a study on admission for dorsalgia in England4 found a LOS of 2.7 days in 2014. Brazilian studies report a longer hospital LOS of 6.857 to 8.356 days, while earlier US studies suggest an average of 3.711 to 4.8 days 58. A study from Switzerland reports a hospital LOS of 7.841 days, while a study from neighbouring Italy reports a hospital LOS of ~15 days19 for lumbago and lumbosciatica.…”

“…We analysed the proportion of low back pain admissions from ED from 3 government reports25 28 43 and 20 peer-reviewed studies14 16–19 40 42–56 (table 1). Seven studies were from healthcare systems with predominantly private funding, 16 with predominantly public funding.…”