Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
PLoS One. 2022 May 10;17(5):e0268123. doi: 10.1371/journal.pone.0268123. eCollection 2022.
Low back pain is a common presentation to emergency departments, but the reasons why people choose to attend the emergency department have not been explored. We aimed to fill this gap with this study to understand why persons with low back pain choose to attend the emergency department. Between July 4, 2017 and October 1, 2018, consecutive patients with a complaint of low back pain presenting to the University of Alberta Hospital emergency department were screened. Those enrolled completed a 13-item questionnaire to assess reasons and expectations related to their presentation. Demographics, acuity and disposition were obtained electronically. Factors associated with admission were examined in a logistic regression model. After screening 812 patients, 209 participants met the study criteria. The most common Canadian Triage and Acuity Scale score was 3 (73.2%). Overall, 37 (17.7%) received at least one consultation, 89.0% of participants were discharged home, 9.6% were admitted and 1.4% were transferred. Participants had a median pain intensity of 8/10 and a median daily functioning of 3/10. When asked, 64.6% attended for pain control while 44.5% stated ease of access. Most participants expected to obtain pain medication (67%) and advice (56%). Few attended because of cost savings (3.8%). After adjustment, only advanced age and ambulance arrival were significantly associated with admission. In conclusion, most low back pain patients came to the emergency department for pain control yet few were admitted and the majority did not receive a consultation. Timely alternatives for management of low back pain in the emergency department appear needed, yet are lacking.
腰痛是急诊科常见的就诊原因，但人们选择去急诊科的原因尚未得到探讨。我们旨在通过这项研究填补这一空白，以了解腰痛患者选择去急诊科的原因。在 2017 年 7 月 4 日至 2018 年 10 月 1 日期间，对连续出现腰痛症状并到阿尔伯塔大学医院急诊科就诊的患者进行了筛选。入选的患者完成了一份包含 13 个问题的问卷，以评估与就诊相关的原因和期望。通过电子方式获取人口统计学、严重程度和处置信息。使用逻辑回归模型检查与入院相关的因素。在筛选了 812 名患者后，有 209 名符合研究标准。最常见的加拿大分诊和 acuity 量表评分为 3 分（73.2%）。总体而言，37 名（17.7%）患者至少接受了一次会诊，98.0%的患者被送回家，9.6%的患者被收治入院，1.4%的患者被转院。患者的中位数疼痛强度为 8/10，中位数日常功能为 3/10。当被问及原因时，64.6%的患者因疼痛控制而就诊，而 44.5%的患者表示就诊方便。大多数患者期望获得止痛药物（67%）和建议（56%）。因节省费用而就诊的患者很少（3.8%）。调整后，只有年龄较大和使用救护车与入院显著相关。总之，大多数腰痛患者到急诊科就诊是为了控制疼痛，但很少有患者被收治入院，而且大多数患者没有接受会诊。因此，急诊科治疗腰痛的及时替代方法似乎是必要的，但却缺乏这些方法。
