Profile of Patients With Acute Low Back Pain Who Sought Emergency Departments: A Cross-sectional Study.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Mar 2020
01 Mar 2020
Historique:
entrez:
12
2
2020
pubmed:
12
2
2020
medline:
1
7
2020
Statut:
ppublish
Résumé
A cross-sectional study. The aim of this study is to describe the profile of patients with acute low back pain (LBP) who sought emergency departments (EDs) in Brazilian public hospitals. We also described the profile of these patients according to the STarT Back Screening Tool (SBST). LBP is the most common musculoskeletal condition worldwide and is one of the main complaints in EDs. There is a lack of evidence describing the profile of these patients from low- to middle-income countries. This is a cross-sectional study involving patients with a new episode of nonspecific acute LBP that was conducted between August 2014 and August 2016. Variables related to clinical, psychological, sociodemographic and work status characteristics were investigated through structured, in-person oral questionnaire. A total of 600 patients were included in the study. The majority of the patients were women (58%), with a median of eight points on pain intensity (measured on an 11-point scale) and 17 points on disability (measured on a 24-item questionnaire). With regards to the SBST evaluation, 295 (49.2%) patients were classified as being at high risk of developing an unfavorable prognosis with a median pain intensity of nine points on pain intensity, 20 points on disability, and seven points on depression (measured on an 11-point scale). Despite this, the majority of the patients (74%) continued working normally without interference from LBP. Identifying the profile of patients seeking care in EDs can help to define effective management for LBP in low- and middle-income countries. Patients with nonspecific acute LBP who seek EDs in Brazil present high levels of pain intensity and disability. Most patients were classified as having a high risk of developing an unfavorable prognosis. 2.
Sections du résumé
STUDY DESIGN
METHODS
A cross-sectional study.
OBJECTIVE
OBJECTIVE
The aim of this study is to describe the profile of patients with acute low back pain (LBP) who sought emergency departments (EDs) in Brazilian public hospitals. We also described the profile of these patients according to the STarT Back Screening Tool (SBST).
SUMMARY OF BACKGROUND DATA
BACKGROUND
LBP is the most common musculoskeletal condition worldwide and is one of the main complaints in EDs. There is a lack of evidence describing the profile of these patients from low- to middle-income countries.
METHODS
METHODS
This is a cross-sectional study involving patients with a new episode of nonspecific acute LBP that was conducted between August 2014 and August 2016. Variables related to clinical, psychological, sociodemographic and work status characteristics were investigated through structured, in-person oral questionnaire.
RESULTS
RESULTS
A total of 600 patients were included in the study. The majority of the patients were women (58%), with a median of eight points on pain intensity (measured on an 11-point scale) and 17 points on disability (measured on a 24-item questionnaire). With regards to the SBST evaluation, 295 (49.2%) patients were classified as being at high risk of developing an unfavorable prognosis with a median pain intensity of nine points on pain intensity, 20 points on disability, and seven points on depression (measured on an 11-point scale). Despite this, the majority of the patients (74%) continued working normally without interference from LBP.
CONCLUSION
CONCLUSIONS
Identifying the profile of patients seeking care in EDs can help to define effective management for LBP in low- and middle-income countries. Patients with nonspecific acute LBP who seek EDs in Brazil present high levels of pain intensity and disability. Most patients were classified as having a high risk of developing an unfavorable prognosis.
LEVEL OF EVIDENCE
METHODS
2.
Identifiants
pubmed: 32045404
doi: 10.1097/BRS.0000000000003253
pii: 00007632-202003010-00015
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E296-E303Références
Rizzardo A, Miceli L, Bednarova R, et al. Low-back pain at the emergency department: Still not being managed? Ther Clin Risk Manag 2016; 12:183–187.
Vos T, Abajobir AA, Abbafati C, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1211–1259.
Almeida M, Saragiotto B, Richards B, et al. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. Med J Aust 2018; 208:272–275.
Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet 2018; 391:2356–2367.
Goubert D, Danneels L, Graven-Nielsen T, et al. Differences in pain processing between patients with chronic low back pain, recurrent low back pain, and fibromyalgia. Pain Physician 2017; 20:307–318.
Friedman BW, Gensler S, Yoon A, et al. Predicting three-month functional outcomes after an ED visit for acute low back pain. Am J Emerg Med 2017; 35:299–305.
Bellan M, Molinari R, Castello L, et al. Profiling the patients visiting the emergency room for musculoskeletal complaints: characteristics and outcomes. Clin Rheumatol 2016; 35:2835–2839.
Machado GC, Rogan E, Maher CG. Managing non-serious low back pain in the emergency department: time for a change? Emerg Med Australas 2018; 30:279–282.
Edwards J, Hayden J, Asbridge M, et al. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord 2017; 18:1–12.
Machado GC, Richards B, Needs C, et al. Implementation of an evidence-based model of care for low back pain in emergency departments: protocol for the Sydney Health Partners Emergency Department (SHaPED) trial. BMJ Open 2018; 8:19052.
Carret MLV, Fassa AG, Kawachi I. Demand for emergency health service: factors associated with inappropriate use. BMC Health Serv Res 2007; 7:1–9.
Buchbinder R, van Tulder M, Oberg B, et al. Low back pain: a call for action. Lancet 2018; 391:2384–2388.
Friedman BW, Chilstrom M, Bijur PE, et al. Diagnostic testing and treatment of low back pain in United States emergency departments: a national perspective. Spine (Phila Pa 1976) 2010; 35:E1406–E1411.
Kohns DJ, Haig AJ, Uren B, et al. Clinical predictors of the medical interventions provided to patients with low back pain in the emergency department. J Back Musculoskelet Rehabil 2018; 31:197–204.
Lovegrove MT, Jelinek GA, Gibson NP, et al. Analysis of 22,655 presentations with back pain to Perth emergency departments over five years. Int J Emerg Med 2011; 4:59.
Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018; 391:2368–2383.
Ferreira G, Costa LM, Stein A, et al. Tackling low back pain in Brazil: a wake-up call. Braz J Phys Ther 2019; 23:189–195.
Medeiros FC, Costa LOP, Oliveira IS, et al. The use of STarT BACK Screening Tool in emergency departments for patients with acute low back pain: a prospective inception cohort study. Eur Spine J 2018; 27:2823–2830.
Sowden G, Hill JC, Morso L, et al. Advancing practice for back pain through stratified care (STarT Back). Braz J Phys Ther 2018; 22:255–264.
Henschke N, Maher CG, Refshauge KM, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ 2008; 337:a171.
de Vet HC, Heymans MW, Dunn KM, et al. Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine (Phila Pa 1976) 2002; 27:2409–2416.
Chiarotto A, Boers M, Deyo RA, et al. Core outcome measurement instruments for clinical trials in non-specific low back pain. Pain 2017; 159:1.
Fagundes FRC, Costa LOP, Fuhro FF, et al. Örebro Questionnaire: short and long forms of the Brazilian-Portuguese version. Qual Life Res. Epub ahead of print 2015. DOI: 10.1007/s11136-015-0998-3.
Costa LOP, Maher CG, Latimer J, et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine (Phila Pa 1976) 2008; 33:2459–2463.
Costa LOP, Maher CG, Latimer J, et al. Psychometric characteristics of the Brazilian-Portuguese versions of the Functional Rating Index and the Roland Morris Disability Questionnaire. Spine (Phila Pa 1976). Epub ahead of print 2007. DOI: 10.1097/BRS.0b013e31811eab33.
Kenny DT. Exercise-based rehabilitation for injured workers: programme efficacy and identification of factors predicting programme completion and outcome. Int J Rehabil Res 2000; 23:7–17.
Victora CG, Barreto ML, Do Carmo Leal M, et al. Health conditions and health-policy innovations in Brazil: the way forward. Lancet 2011; 377:2042–2053.
Paim J, Travassos C, Almeida C, et al. The Brazilian health system: History, advances, and challenges. Lancet 2011; 377:1778–1797.
Marinho F, de Azeredo Passos VM, Carvalho Malta D, et al. Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016. Lancet 2018; 6736:1–16.
Nunn ML, Hayden JA, Magee K. Current management practices for patients presenting with low back pain to a large emergency department in Canada. BMC Musculoskelet Disord 2017; 18:1–8.
Thiruganasambandamoorthy V, Turko E, Ansell D, et al. Risk factors for serious underlying pathology in adult emergency department nontraumatic low back pain patients. J Emerg Med 2014; 47:1–11.
Henschke N, Maher CG, Refshauge KM, et al. Characteristics of patients with acute low back pain presenting to primary care in Australia. Clin J Pain 2009; 25:5–11.
Henschke N, Lorenz E, Pokora R, et al. Understanding cultural influences on back pain and back pain research. Best Pract Res Clin Rheumatol 2016; 30:1037–1049.
Pinheiro MB, Ferreira ML, Refshauge K, et al. Symptoms of depression as a prognostic factor for low back pain: a systematic review. Spine J 2016; 16:105–116.
O’Keeffe M, George SZ, O'Sullivan PB, et al. Psychosocial factors in low back pain: letting go of our misconceptions can help management. Br J Sports Med 2019; 53:793–794.
Medeiros FC, Costa LOP, Added MAN, et al. Longitudinal monitoring of patients with chronic low back pain during physical therapy treatment using the STarT back screening tool. J Orthop Sport Phys Ther 2017; 47:314–323.
Hartvigsen J, Lings S, Leboeuf-Yde C, et al. Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies. Occup Environ Med 2004; 61:e2.
Bernstein IA, Malik Q, Carville S, et al. Low back pain and sciatica: summary of NICE guidance. BMJ 2017; 356:i6748.