In Perth, Western Australia, clearly back pain is a different sort of entity than back pain here in the United States. This is a retrospective review of 22,000 back pain representing 1.9% of all visits over a five year period simply as an epidemiologic overview with descriptive statistics.
And, fascinating statistics they are. Highlights:
- 43.8% of patients were diagnosed with simple muscular back pain.
- 17.1% of muscular back pain patients required admission to the hospital with a mean length-of-stay of 6.4 days, and one that was hospitalized for 163 days!
- Patients at the extremes of age (< 15 years, > 75 years) were simple muscular back pain less than 40% of the time.
- Of the medical diseases found in the non-muscular group, the top were renal colic, sciatica, UTI/pyelonephritis.
- 24 myocardial infarctions, 53 pulmonary emboli, 17 aortic dissections, and 18 ruptured AAA were diagnosed in patients with a primary complaint of back pain.
How do 17.1% of simple muscular back pain patients get admitted to the hospital? For six days? It boggles the mind.
Finally - back pain at the harbinger of death - there was a 1.2% 30-day mortality rate in all patients presenting for any complaint of back pain, and 0.8% with non-specific or muscular back pain. That's almost as lethal as our low-risk chest pain cohort here in the U.S.
"Analysis of 22,655 presentations with back pain to Perth emergency departments over five years"