Orlando Joseph F, Burke Anne Lj, Beard Matthew, Guerin Michelle, Kumar Saravana
IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
Emerg Med Australas. 2025 Feb;37(1):e14504. doi: 10.1111/1742-6723.14504. Epub 2024 Sep 18.
The present study sought to investigate predictors of hospitalisation in adults diagnosed with non-specific low back pain (LBP) and/or sciatica from an ED.
A 5-year, multicentre retrospective observational study was conducted across six public hospitals (metropolitan and regional) using data from electronic medical records. Patient presentations were identified using LBP diagnostic codes and key data extracted (patient demographics, clinical activity, discharge destination). Descriptive statistics and logistic regression were used to measure associations between identified variables and hospitalisation.
There were 11 709 ED presentations across the study period. People aged ≥65 years (odds ratio [OR] 2.84, 95% confidence interval [CI] 2.61-3.10) and those who arrived at the ED via ambulance (age-adjusted OR 2.68, 95% CI 2.44-2.95) were more likely to be hospitalised. People were also more likely to be hospitalised when triaged as more urgent, when blood tests or advanced spinal imaging were ordered, and when i.v./subcutaneous opioids or oral benzodiazepines were administered. Hospitalisation rates for LBP were lower in regional hospitals, in people residing in lower socioeconomic areas and in Indigenous Australians.
Certain patient characteristics and ED clinical activity are associated with hospitalisations for LBP. Understanding these factors will better inform the design and delivery of appropriate high-quality care.
本研究旨在调查急诊科诊断为非特异性腰痛（LBP）和/或坐骨神经痛的成人患者住院治疗的预测因素。
利用电子病历数据，在六家公立医院（大城市和地区性医院）开展了一项为期5年的多中心回顾性观察研究。通过LBP诊断代码识别患者就诊情况，并提取关键数据（患者人口统计学信息、临床活动、出院去向）。采用描述性统计和逻辑回归分析来衡量所确定变量与住院治疗之间的关联。
在研究期间共有11709例患者到急诊科就诊。年龄≥65岁的患者（比值比[OR]为2.84，95%置信区间[CI]为2.61 - 3.10）以及通过救护车送至急诊科的患者（年龄调整后的OR为2.68，95%CI为2.44 - 2.95）更有可能住院。当分诊为更紧急时、当进行血液检查或高级脊柱成像检查时以及当给予静脉注射/皮下注射阿片类药物或口服苯二氮䓬类药物时，患者也更有可能住院。地区医院、社会经济地位较低地区的居民以及澳大利亚原住民中LBP的住院率较低。
某些患者特征和急诊科临床活动与LBP患者的住院治疗有关。了解这些因素将有助于更好地设计和提供适当的高质量护理。
