Diagnostic testing and treatment of low back pain in United States emergency departments: a national perspective

This study is an analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS), a large sample representative of all emergency department (ED) visits throughout the United States. To use NHAMCS to describe the frequency of ED visits for the treatment of low back pain, and the diagnostic...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2010-11, Vol.35 (24), p.E1406-E1411
Main Authors: Friedman, Benjamin W, Chilstrom, Mikaela, Bijur, Polly E, Gallagher, E John
Format: Article
Language:English
Subjects:
Adult
Age Factors
Ambulatory Care - statistics & numerical data
Analgesics - therapeutic use
Diagnostic Imaging - methods
Drug Prescriptions - statistics & numerical data
Drug Utilization
Emergency Service, Hospital - statistics & numerical data
Female
Guideline Adherence
Health Care Surveys
Humans
Insurance, Health - statistics & numerical data
Logistic Models
Low Back Pain - diagnosis
Low Back Pain - therapy
Magnetic Resonance Imaging
Male
Middle Aged
Odds Ratio
Outcome and Process Assessment (Health Care) - statistics & numerical data
Patient Discharge - statistics & numerical data
Practice Guidelines as Topic
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
United States
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Summary:This study is an analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS), a large sample representative of all emergency department (ED) visits throughout the United States. To use NHAMCS to describe the frequency of ED visits for the treatment of low back pain, and the diagnostic and therapeutic strategies employed by emergency clinicians. Low back pain is common in the general population. While it accounts for 2.5% of all outpatient office visits, the role of the ED has yet to be described. We included cases if they had both a reason for visit related to back pain and a primary ED discharge ICD9 code consistent with low back pain. The outcomes included frequency of ED use, and frequency of various diagnostic and therapeutic strategies. Individual patient visits are weighted so that data can be extrapolated to all ED visits throughout the United States. Low back pain related disorders caused 2.63 million (95% CI: 2.32, 2.93 million) annual ED visits in the US. Of all patients with low back pain, 30.5% (28.1, 32.9) had a plain radiograph; 9.6% (95% CI: 7.2, 12.6) had a CT or MRI in 2006 compared with 3.2% (95% CI: 2.0, 5.1) in 2002 (P for trend
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0b013e3181d952a5