UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia.
Central Adelaide Local Health Network, Adelaide, Australia.
PLoS One. 2023 Oct 10;18(10):e0292648. doi: 10.1371/journal.pone.0292648. eCollection 2023.
Significant costs and utilisation of healthcare resources are associated with hospitalisations for non-specific low back pain despite clinical guidelines recommending community-based care. The aim of this systematic review was to investigate the predictors of hospitalisation for low back pain. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42021281827) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Database search of Ovid Medline, Emcare, Embase, PsycINFO, Cochrane Library, PEDro and OTSeeker was conducted. Studies were included if they examined a predictor of hospitalisation for non-specific low back pain with or without referred leg pain. Data was extracted and descriptively synthesised. Risk of bias of included studies was assessed using the Critical Appraisal Skills Programme Checklists. There were 23 studies published over 29 articles which identified 52 predictor variables of hospitalisation for low back pain. The risk of hospitalisation was grouped into themes: personal, health and lifestyle, psychology, socioeconomic, occupational, clinical, and health systems and processes. There was moderate level evidence that arrival to an emergency department via ambulance with low back pain, and older age increase the risk of hospitalisations for low back pain. There was low level evidence that high pain intensity, past history of low back pain, opioid use, and occupation type increase the risk of hospitalisation for low back pain. Further research into psychological and social factors is warranted given the paucity of available studies. Hospital avoidance strategies, improved patient screening and resource utilisation in emergency departments are considerations for practice.
尽管临床指南推荐基于社区的护理，但与非特异性下腰痛住院相关的医疗保健资源的显著成本和利用仍存在。本系统评价的目的是调查下腰痛住院的预测因素。该方案已在 PROSPERO 国际前瞻性系统评价注册库（#CRD42021281827）中注册，并按照系统评价和荟萃分析的首选报告项目（PRISMA）2020 声明进行。对 Ovid Medline、Emcare、Embase、PsycINFO、Cochrane Library、PEDro 和 OTSeeker 进行了数据库检索。如果研究检查了非特异性下腰痛（伴有或不伴有放射痛）住院的预测因素，则将其纳入研究。提取数据并进行描述性综合。使用批判性评估技能计划清单评估纳入研究的偏倚风险。有 23 项研究发表在 29 篇文章中，确定了 52 个下腰痛住院的预测变量。住院风险分为以下主题：个人、健康和生活方式、心理、社会经济、职业、临床以及卫生系统和流程。有中等质量证据表明，因腰痛而乘坐救护车到达急诊科以及年龄较大增加了下腰痛住院的风险。有低质量证据表明，高疼痛强度、过去的腰痛史、阿片类药物的使用以及职业类型增加了下腰痛住院的风险。鉴于现有研究数量有限，有必要进一步研究心理和社会因素。避免住院的策略、改进急诊科的患者筛选和资源利用是实践中的考虑因素。
