Predicting three-month functional outcomes after an ED visit for acute low back pain

Friedman, Benjamin W.; Gensler, Stuart; Yoon, Andrew; Nerenberg, Rebecca; Holden, Lynne; Bijur, Polly E.; Gallagher, E. John

doi:10.1016/j.ajem.2016.11.014

Cited by 16 publications

(15 citation statements)

References 19 publications

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“…During a structured telephone interview 1 week after the index visit, patients described their LBP as “severe,” “moderate,” “mild,” or “none.” The 1‐week pain level, dichotomized into “some pain” or “no pain,” was used to predict 3‐month outcomes. One‐week pain scores have been associated with poor long‐term LBP outcomes in previous work …”

Section: Methodsmentioning

confidence: 87%

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Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three‐month Outcomes

Friedman

Conway

Campbell

et al. 2018

Academic Emergency Medicine

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More than one-third of patients reported functional impairment 3 months after an ED visit for acute, nontraumatic, nonradicular LBP. Moderate or severe LBP was less common, reported in about half as many patients (16%). Of the three hypothesized predictor variables, only persistent pain at 1 week was independently associated with poor outcomes at 3 months. Despite its important role in the outpatient setting, the STarT Back Tool was not associated with poor outcomes in this ED cohort.

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Section: Methodsmentioning

confidence: 87%

“… The STarT Back Tool, a nine‐item, multidimensional low back prediction instrument that has been validated and is widely used in the outpatient setting; The patient's own prediction, in days, of anticipated LBP duration; The presence or absence of LBP 1 week after the ED visit, as assessed during a follow‐up phone call …”

mentioning

confidence: 99%

Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three‐month Outcomes

Friedman

Conway

Campbell

et al. 2018

Academic Emergency Medicine

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“…Findings of these two reviews are therefore limited in generalizability to these LBP subgroups. Moreover, many primary studies have been published in this area since 2014 [37][38][39][40][41][42][43][44][45][46][47], particularly around disability, medication use, and surgical outcomes. A comprehensive and up-todate systematic review is needed to inform future research and practice, and improve health services delivery and quality of care for LBP.…”

Section: Introductionmentioning

confidence: 99%

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

et al. 2019

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Background: A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods: Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/ depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion: The impact of depressive symptoms and depression on health-and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration: PROSPERO CRD42019130047

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“…Emergency Departments (ED) are designed to provide patients immediate, unscheduled medical care for acute illnesses and injuries. However, frequent revisits to the ED by a small percentage of patients with chronic conditions or complaints contribute to long wait times and delayed admission of those with critical needs [1][2][3][4][5][6][7][8][9]. Many studies have implicated depression as a strong predictor of those that present to the ED, especially with complaints of acute or chronic pain and those who present with high frequency [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Depression Linked to Frequent Emergency Department Use in Large 10-year Retrospective Analysis of an Integrated Health Care System

Ingram

Weston

Ritchie

et al. 2017

Preprint

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We evaluated general patient features related to depression and frequency of Emergency Department (ED) use in a large integrated health care system. Electronic Health Records of 287,281 adults from a general patient population were studied retrospectively over a 10-year period. Patients with a history of depression were more likely to be seen in the ED and at higher frequency than those without. Frequent ED users were more likely to have a history of depression or psychiatric medication orders than infrequent users. ED visits by depression patients and frequent users have highly correlated complaints and discharge diagnoses with other ED users, often related to pain. Poorly managed depression may be playing a role in frequent ED utilization which may be addressed by universal screening for depression, evaluation of barriers to treatment, and other novel interventions to improve care coordination.

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Predicting three-month functional outcomes after an ED visit for acute low back pain

Cited by 16 publications

References 19 publications

Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three‐month Outcomes

Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three‐month Outcomes

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

Depression Linked to Frequent Emergency Department Use in Large 10-year Retrospective Analysis of an Integrated Health Care System

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