Nagayama Masataka, Yanagawa Youichi, Aihara Koichiro, Watanabe Shin, Takemoto Masaaki, Nakazato Tomoko, Hashimoto Takashi, Takayama Toshio, Takazawa Yuuji, Iba Toshiaki, Kaneko Kazuo, Tanaka Hiroshi
Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan.
Department of Orthopedics Juntendo University Tokyo Japan.
Acute Med Surg. 2014 Jan 28;1(2):94-100. doi: 10.1002/ams2.16. eCollection 2014 Apr.
To investigate epidemiology of acute non-traumatic back pain using modern diagnostic methods in patients who visited an emergency room.
The medical charts were retrospectively reviewed for all patients with back pain who were treated in our hospital. In addition, the patients were divided into two groups based on whether they were treated at the hospital or as outpatients.
There were 95 patients with non-traumatic acute back pain. Leading cause of back pain was ureterolithiasis (53 cases), followed by pyelonephritis (10), orthopedic disease including two cases of purulent spondylitis (24), aortic disease (3), pancreatitis (1), renal bleeding (1), adrenal bleeding (1), psoas abscess (1), and torsion of an ovarian tumor (1). All cases of pyelonephritis, aortic disease, purulent spondylitis, renal bleeding, adrenal bleeding, psoas abscess, and torsion of an ovarian tumor were treated in admission. Using a multiple logistic regression analysis, blood pressure, age, and body temperature were the only factors that were independently associated with whether the patient was admitted or treated as an outpatient.
This study showed that urological diseases are the most common cause of back pain in patients who visit the emergency room, followed by orthopedic disease. Older age, low blood pressure, and high body temperature were independently associated with the decision to admit the patient who might have lethal disease.
采用现代诊断方法调查急诊室就诊患者急性非创伤性背痛的流行病学情况。
对我院治疗的所有背痛患者的病历进行回顾性审查。此外，根据患者是在医院接受治疗还是门诊治疗将其分为两组。
有95例非创伤性急性背痛患者。背痛的主要原因是输尿管结石（53例）,其次是肾盂肾炎（10例）、骨科疾病（包括2例化脓性脊柱炎，共24例）、主动脉疾病（3例）、胰腺炎（1例）、肾出血（1例）、肾上腺出血（1例）、腰大肌脓肿（1例）和卵巢肿瘤扭转（1例）｡所有肾盂肾炎、主动脉疾病、化脓性脊柱炎、肾出血、肾上腺出血、腰大肌脓肿和卵巢肿瘤扭转病例均在入院时接受治疗。采用多元逻辑回归分析，血压、年龄和体温是与患者入院或门诊治疗独立相关的唯一因素。
本研究表明，泌尿系统疾病是急诊室就诊患者背痛的最常见原因,其次是骨科疾病。年龄较大、血压低和体温高与收治可能患有致命疾病患者的决定独立相关。
