Outcomes of Patients Admitted to Hospital Medical Units with Back Pain.

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Outcomes of Patients Admitted to Hospital Medical Units with Back Pain.

Intern Med J. 2018 Aug 08;:

Authors: Kyi L, Kandane-Rathnayake R, Morand E, Roberts LJ

BACKGROUND: Hospital admissions for patients with back pain are increasing. Despite their significant contribution to the health-care burden they remain largely unstudied.
AIM: To investigate the management and clinical outcomes of patients with acute back pain admitted to hospital under general medicine units when compared to a rheumatology unit.
METHODS: A 36-month retrospective, observational study on patients presenting to the Emergency Department with back pain who were subsequently admitted to 1 of 3 General Medicine Units (GM) or a Rheumatology Unit (RU).
MAIN OUTCOME MEASURES: Differences in patient demographics, management and clinical outcomes were assessed using Chi-Squared tests for categorical variables and Kruskall Wallis tests for continuous variables. Multivariate associations of two primary outcomes, length of stay (LOS) and complications were examined using generalised estimating equations.
RESULTS: Data from 712 admissions from 594 patients across the 4 inpatient units were used for this study. Common discharge diagnoses were musculoskeletal/nonspecific back pain (41%), disc related illness (22%), vertebral fracture (14%) and sciatica (14%). Non-English speaking background, age ≥80 years, disc related disease, vertebral fracture and sciatica were statistically significantly associated with both increased LOS and complications. The presence of comorbidities was associated with more complications. GM admission was associated with a longer LOS and more complications than RU admission.
CONCLUSION: Multiple factors associated with an increased LOS and complications were identified, including older patients, patients of non-English speaking background. Given the observed variations in back pain management between general and specialty units, strategies to standardise care should be considered. This article is protected by copyright. All rights reserved.

PMID: 30091257 [PubMed - as supplied by publisher]

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