Fellner Anuva, Kim Howard S
Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Center for Dissemination & Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, IL.
Ann Emerg Med. 2025 Jul 11. doi: 10.1016/j.annemergmed.2025.06.005.
Low back pain is a common reason for visiting the emergency department (ED). Updated and reliable national estimates of usual care for low back pain are needed to identify research and quality improvement priorities to improve patient outcomes and reduce low-value emergency care.
This is a cross-sectional study of the National Hospital Ambulatory Medical Care Survey from 2016 to 2022. We identified ED visits with a back pain-related reason for visit and used the National Hospital Ambulatory Medical Care sampling weights to produce national estimates of usual diagnostic and therapeutic care variables.
From 2016 to 2022, there were an estimated 52.8 million ED visits for low back pain (mean age 45.4 years, 60.3% women, 56.4% non-Hispanic White, and 31.1% Medicaid), accounting for 5.3% of all ED visits. The mean numeric pain score of ED visits for back pain was 7.2 out of 10; 13.7% of visits arrived by ambulance and 40.4% were related to injury or trauma. Mean waiting room time and total ED length of stay were 36.5 and 236.6 minutes, respectively. In 2016, opioids were administered or prescribed in 35.0% and 32.5% of visits for back pain, respectively, and by 2022, opioids were administered or prescribed in 24.5% and 13.5% of visits, respectively. Radiographs were obtained in 39.4% of ED visits. Both opioid prescribing and radiographs were most prevalent in patients 75 years or older.
This study presents updated and reliable national estimates of usual diagnostic and therapeutic emergency care for low back pain from 2016 to 2022, which may be used for national benchmarking and quality improvement efforts.
腰痛是急诊就诊的常见原因。需要更新且可靠的全国性腰痛常规护理估计数据，以确定研究重点和质量改进重点，从而改善患者治疗效果并减少低价值的急诊护理。
这是一项对2016年至2022年全国医院门诊医疗调查的横断面研究。我们确定了因腰痛相关原因就诊的急诊病例，并使用全国医院门诊医疗抽样权重来得出常规诊断和治疗护理变量的全国估计值。
2016年至2022年期间，估计有5280万例因腰痛就诊的急诊病例（平均年龄45.4岁，女性占60.3%，非西班牙裔白人占56.4%，医疗补助计划参保者占31.1%），占所有急诊病例的5.3%。腰痛急诊病例的平均数字疼痛评分（满分10分）为7.2分；13.7%的病例通过救护车送达，40.4%的病例与损伤或创伤有关。平均候诊时间和急诊总留观时间分别为36.5分钟和236.6分钟。2016年，分别有35.0%和32.5%的腰痛就诊病例接受了阿片类药物注射或处方，到2022年，这一比例分别降至24.5%和13.5%。39.4%的急诊病例进行了X光检查。阿片类药物处方和X光检查在75岁及以上患者中最为普遍。
本研究提供了2016年至2022年期间腰痛常规诊断和治疗急诊护理的更新且可靠的全国估计数据，可用于全国基准设定和质量改进工作。
