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.
Fascinating.
“Analysis of 22,655 presentations with back pain to Perth emergency departments over five years”
www.ncbi.nlm.nih.gov/pubmed/21923920
G'day,
In the mixed public/ private system present in Australia it would not surprise me if the disposition and LOS of muscular back pain were somehow linked to whether or not the patient had private medical insurance.
Was there any data on that?
C
disposition and LOS of muscular back pain is related to the 4hr rule and inpatient teams not being particularly interested in back pain. in addition, after garling, in NSW ED gets to force admission under their inpatient team of choice.