Health-Related Quality of Life of Patients Presenting to the Emergency Department with a Musculoskeletal Disorder

• Published in: ClinicoEconomics and outcomes research 2022-01, Vol.14, p.91-103
• Main Authors: Gagnon, Rose, Perreault, Kadija, Guertin, Jason R, Berthelot, Simon, Achou, Bertrand, Hébert, Luc J
• Format: Article
• Language: English
• Subjects: Analysis; Chronic pain; Emergency service; emergency services; eq-5d-5l; Hospitals; musculoskeletal disorders; Original Research; pain; quality of life
• ISSN: 1178-6981; 1178-6981
• DOI: 10.2147/CEOR.S348138

Musculoskeletal disorders (MSKDs) are among the most disabling and costly non-fatal health conditions. They may lead to long-term consequences such as chronic pain, physical limitations, and poorer quality of life. They also account for a significant proportion of emergency department visits, representing between 18% and 25% of all visits, depending on country. To assess the health-related quality of life of patients presenting to the emergency department with a MSKD, to convert their answers to utility scores and to explore the association between diverse socio-demographic and clinical variables and patients' health-related quality of life. This is an analysis of cross-sectional data obtained during the baseline assessment performed as part of a 6-month pragmatic randomized controlled trial conducted in an academic emergency department. We included patients aged 18-80 years with a minor MSKD. The main outcome measures were health-related quality of life (five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and utility scores (-0.148 - worse than death, 0 - dead, 0.949 - perfect health) measured with the EQ-5D-5L. Possible associations were explored by comparing scores across subgroups based on certain socio-demographic (eg, age, gender, triage score) and clinical factors (eg, pain interference on function, pain intensity) and with reference values using descriptive statistics (mean, median), rankFD ANOVAs, and tests. Sixty-nine participants completed the EQ-5D-5L. Mean and median utility scores were, respectively, 0.536 (95% CI: 0.479-0.594) and 0.531 (IQR: 0.356-0.760). Participants with higher levels of pain (7/10: 0.433, 0.347-0.518) or pain interference on function (7/10: 0.294, 0.126-0.463) presented significantly lower utility scores. No significant differences were found for other socio-demographic characteristics. In patients with MSKDs who present to the emergency department, higher levels of pain or pain interference are associated with decreased health-related quality of life. These findings need to be confirmed on a larger scale.