Display options
Cite
Rizzardo A, Miceli L, Bednarova R, et al. Low-back pain at the emergency department: still not being managed?. Ther Clin Risk Manag. 2016;12:183-7doi: 10.2147/TCRM.S91898.
Rizzardo, A., Miceli, L., Bednarova, R., Guadagnin, G. M., Sbrojavacca, R., & Della Rocca, G. (2016). Low-back pain at the emergency department: still not being managed?. Therapeutics and clinical risk management, 12183-7. https://doi.org/10.2147/TCRM.S91898
Rizzardo, Alessandro, et al. "Low-back pain at the emergency department: still not being managed?." Therapeutics and clinical risk management vol. 12 (2016): 183-7. doi: https://doi.org/10.2147/TCRM.S91898
Rizzardo A, Miceli L, Bednarova R, Guadagnin GM, Sbrojavacca R, Della Rocca G. Low-back pain at the emergency department: still not being managed?. Ther Clin Risk Manag. 2016 Feb 12;12:183-7. doi: 10.2147/TCRM.S91898. eCollection 2016. PMID: 26929631; PMCID: PMC4758795.
Copy Download .nbib Format: NLM
Share it on

Ther Clin Risk Manag. 2016 Feb 12;12:183-7. doi: 10.2147/TCRM.S91898. eCollection 2016.

Low-back pain at the emergency department: still not being managed?.

Therapeutics and clinical risk management

Alessandro Rizzardo, Luca Miceli, Rym Bednarova, Giovanni Maria Guadagnin, Rodolfo Sbrojavacca, Giorgio Della Rocca

Affiliations

  1. Department of Anesthesia and Intensive Care, Academic Hospital of Udine, University of Udine, Udine, Italy.
  2. Pain Medicine and Palliative Care, Health Company Number 2, Gorizia, Italy.
  3. Emergency Department, Academic Hospital of Udine, Udine, Italy.

PMID: 26929631 PMCID: PMC4758795 DOI: 10.2147/TCRM.S91898

Abstract

BACKGROUND: Low-back pain (LBP) affects about 40% of people at some point in their lives. In the presence of "red flags", further tests must be done to rule out underlying problems; however, biomedical imaging is currently overused. LBP involves large in-hospital and out-of-hospital economic costs, and it is also the most common musculoskeletal disorder seen in emergency departments (EDs).

PATIENTS AND METHODS: This retrospective observational study enrolled 1,298 patients admitted to the ED, including all International Classification of Diseases 10 diagnosis codes for sciatica, lumbosciatica, and lumbago. We collected patients' demographic data, medical history, lab workup and imaging performed at the ED, drugs administered at the ED, ED length of stay (LOS), numeric rating scale pain score, admission to ward, and ward LOS data. Thereafter, we performed a cost analysis.

RESULTS: Mean numeric rating scale scores were higher than 7/10. Home medication consisted of no drug consumption in up to 90% of patients. Oxycodone-naloxone was the strong opioid most frequently prescribed for the home. Once at the ED, nonsteroidal anti-inflammatory drugs and opiates were administered to up to 72% and 42% of patients, respectively. Imaging was performed in up to 56% of patients. Mean ED LOS was 4 hours, 14 minutes. A total of 43 patients were admitted to a ward. The expense for each non-ward-admitted patient was approximately €200 in the ED, while the mean expense for ward-admitted patients was €9,500, with a mean LOS of 15 days.

CONCLUSION: There is not yet a defined therapeutic care process for the patient with LBP with clear criteria for an ED visit. It is to this end that we need a clinical pathway for the prehospital management of LBP syndrome and consequently for an in-hospital time-saving therapeutic approach to the patient.

Keywords: cost analysis; emergency department; health policies; low-back pain

References

  1. Lancet. 2012 Dec 15;380(9859):2163-96 - PubMed
  2. Pain. 1994 Apr;57(1):117-23 - PubMed
  3. Am Fam Physician. 2012 Feb 15;85(4):343-50 - PubMed
  4. Pain Pract. 2013 Apr;13(4):345 - PubMed
  5. J Clin Anesth. 2004 May;16(3):159-67 - PubMed
  6. Spine (Phila Pa 1976). 2011 Oct 1;36(21 Suppl):S131-43 - PubMed
  7. Lancet. 2009 Feb 7;373(9662):463-72 - PubMed
  8. Emerg Med Pract. 2013 Jul;15(7):1-23; Quiz 23-4 - PubMed
  9. N Z Med J. 2007 May 18;120(1254):U2536 - PubMed
  10. Radiology. 2004 May;231(2):343-51 - PubMed
  11. Reg Anesth Pain Med. 1999 Jan-Feb;24(1):68-73 - PubMed
  12. Spine (Phila Pa 1976). 2002 Oct 15;27(20):2291-7 - PubMed
  13. Eur J Pain. 2006 May;10(4):287-333 - PubMed
  14. Arthritis Rheum. 2012 Jun;64(6):2028-37 - PubMed

Publication Types