Edwards Jordan, Hayden Jill, Asbridge Mark, Gregoire Bruce, Magee Kirk
Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
BMC Musculoskelet Disord. 2017 Apr 4;18(1):143. doi: 10.1186/s12891-017-1511-7.
Low back pain may be having a significant impact on emergency departments around the world. Research suggests low back pain is one of the leading causes of emergency department visits. However, in the peer-reviewed literature, there has been limited focus on the prevalence and management of back pain in the emergency department setting. The aim of the systematic review was to synthesize evidence about the prevalence of low back pain in emergency settings and explore the impact of study characteristics including type of emergency setting and how the study defined low back pain.
Studies were identified from PubMed and EMBASE, grey literature search, and other sources. We selected studies that presented prevalence data for adults presenting to an emergency setting with low back pain. Critical appraisal was conducted using a modified tool developed to assess prevalence studies. Meta-analyses and a meta-regression explored the influence of study-level characteristics on prevalence.
We screened 1187 citations and included 21 studies, reported between 2000 and 2016 presenting prevalence data from 12 countries. The pooled prevalence estimate from studies of standard emergency settings was 4.39% (95% CI: 3.67-5.18). Prevalence estimates of the included studies ranged from 0.9% to 17.1% and varied with study definition of low back pain and the type of emergency setting. The overall quality of the evidence was judged to be moderate as there was limited generalizability and high heterogeneity in the results.
This is the first systematic review to examine the prevalence of low back pain in emergency settings. Our results indicate that low back pain is consistently a top presenting complaint and that the prevalence of low back pain varies with definition of low back pain and emergency setting. Clinicians and policy decisions makers should be aware of the potential impact of low back pain in their emergency settings.
腰痛可能对全球急诊科产生重大影响。研究表明，腰痛是急诊科就诊的主要原因之一。然而，在同行评审的文献中，对急诊科环境中腰痛的患病率和管理的关注有限。本系统评价的目的是综合有关急诊科环境中腰痛患病率的证据，并探讨研究特征的影响，包括急诊科类型以及研究如何定义腰痛。
从PubMed、EMBASE、灰色文献搜索和其他来源中识别研究。我们选择了呈现腰痛患者到急诊科就诊的成人患病率数据的研究。使用为评估患病率研究而开发的改良工具进行批判性评价。荟萃分析和元回归探讨了研究水平特征对患病率的影响。
我们筛选了1187篇引文，纳入了21项研究，这些研究报告于2000年至2016年之间，呈现了来自12个国家的患病率数据。标准急诊科环境研究的汇总患病率估计为4.39%（95%CI：3.67-5.18）。纳入研究的患病率估计范围为0.9%至17.1%，并因腰痛的研究定义和急诊科类型而异。由于结果的普遍性有限且异质性高，证据的总体质量被判定为中等。
这是第一项审查急诊科环境中腰痛患病率的系统评价。我们的结果表明，腰痛一直是首要的就诊主诉，并且腰痛的患病率因腰痛的定义和急诊科环境而异。临床医生和政策决策者应意识到腰痛在其急诊科环境中的潜在影响。
