Weiner A L, MacKenzie R S
Division of Emergency Medicine, University of Connecticut School of Medicine, Farmington, USA.
J Emerg Med. 1999 Mar-Apr;17(2):229-33. doi: 10.1016/s0736-4679(98)00158-9.
We sought to determine how often Emergency Physicians (EPs) order plain radiographs (XRs) of the lumbosacral spine in evaluating patients with low back pain (LBP). In addition, we sought to determine what history and physical examination findings were statistically associated with the use of an XR. Patients evaluated in our Emergency Department (ED) between April 1, 1995 and September 30, 1995 for LBP were identified retrospectively by their ICD-9 discharge code. The ED record was reviewed, and an odds ratio (OR) was calculated for each of several history and physical examination findings, to determine which of them increased the likelihood of having an XR. Forty of 214 patients (19%) with LBP had an XR done. Patient characteristics associated with the use of an XR were: a positive straight leg examination, age > 50 years, a history of trauma, and vertebral tenderness. In this series, only a small minority of patients with LBP had an XR done as part of their ED evaluation. The choice of which patients to image was determined by history and physical examination findings. We conclude that the EPs we studied are evaluating LBP as conservatively, if not more so, than physicians in other specialties.
我们试图确定急诊医师（EPs）在评估腰痛（LBP）患者时，开具腰骶部平片（XRs）的频率。此外，我们还试图确定哪些病史和体格检查结果与开具XR存在统计学关联。通过ICD - 9出院编码，对1995年4月1日至1995年9月30日期间在我们急诊科（ED）因LBP接受评估的患者进行回顾性识别。查阅ED记录，并针对多项病史和体格检查结果分别计算比值比（OR），以确定哪些结果会增加开具XR的可能性。214例LBP患者中有40例（19%）进行了XR检查。与开具XR相关的患者特征包括：直腿试验阳性、年龄>50岁、有创伤史以及椎体压痛。在本系列研究中，只有一小部分LBP患者在ED评估时进行了XR检查。对哪些患者进行影像学检查的选择是由病史和体格检查结果决定的。我们得出结论，我们所研究的急诊医师在评估LBP时，即便不比其他专科医师更保守，至少也是同样保守的。
