4169 The influence of serious mental illness on medical care of patients with lower back pain in the emergency department

OBJECTIVES/GOALS: To determine whether length of stay (LOS) and opioid prescribing differ among patients who present to the emergency department (ED) with low back pain (LBP) and serious mental illness (SMI+) compared to patients without SMI (SMI−). METHODS/STUDY POPULATION: Eligible patients that visited the ED within the Mount Sinai Health Care System from 2016-2019 were identified from the Mount Sinai Data Warehouse. Data on patient demographics, number of medications prescribed, and length of stay (LOS) were compared between the groups. Patients were excluded if English was not their primary language and if the LOS exceeded 24 hours. The final dataset consisted of 940 patients (SMI+: n = 181; SMI−: n = 759). RESULTS/ANTICIPATED RESULTS: SMI+ cases included patients with a diagnosis of depression (n = 152), anxiety (n = 134), schizophrenia (n = 9), bipolar (n = 1), and/or post-traumatic stress disorder (n = 33); 26% of cases had a single diagnosis, 66% with two, and the remaining 8% had three diagnoses. There was no significant difference in pain scores between the two groups (SMI-: 7.0 ± 0.1; SMI+: 6.8 ± 0.3; p = 0.6). We found no significant differences in LOS between the groups (SMI-: 3.9 ± 0.1 hours; SMI+: 3.8 ± 0.2 hours; p = 0.8), nor was there a significant difference in number of medications prescribed (SMI-: 1.7 ± 0.9; SMI+: 1.7 ± 0.6; p = 0.4). Further analysis revealed that the odds of receiving an opiate prescription in the SMI- group was 0.92 (95% CI: 0.54,1.55). DISCUSSION/SIGNIFICANCE OF IMPACT: Comparable opioid prescribing and LOS exist in patients with and without serious mental illness who are seeking treatment for low back pain in the ED. Despite similarities in approaches to care, more information is needed to determine if other social determinants influence these practices.

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Erector spinae plane block: a new option for managing acute axial low back pain in the emergency department

Pain Management ◽

10.2217/pmt-2021-0004 ◽

2021 ◽

Author(s):

Alexander J Anshus ◽

Jessica Oswald

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Length Of Stay ◽

Case Series ◽

Erector Spinae ◽

Low Back ◽

Analog Scale ◽

Acute Low Back Pain ◽

Erector Spinae Plane Block

Aim: To evaluate pain and length of stay outcomes in six patients who received an erector spinae plane block (ESPB) in the emergency department (ED) for low back pain. Materials & methods: A case series of six patients who received unilateral or bilateral ESPB after presenting to the ED for acute atraumatic axial low back pain. Results: The average visual analog scale pain score reduction was 81.8%, and length of stay after ESPB was 73.5 min. No postprocedure opiates in the ED or after discharge were required. Conclusion: The ESPB is a rapid, safe and opiate-sparing option for the treatment of acute low back pain.

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Frequency of Opioid Prescribing for Acute Low Back Pain in a Rural Emergency Department

Advanced Emergency Nursing Journal ◽

10.1097/tme.0000000000000310 ◽

2020 ◽

Vol 42 (3) ◽

pp. 210-214

Author(s):

Jean E. Jauregui ◽

Rita J. Nutt ◽

Asa M. Margolis

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Opioid Prescribing ◽

Acute Low Back Pain

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Extent and Impact of Opioid Prescribing for Acute Occupational Low Back Pain in the Emergency Department

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2015.10.015 ◽

2016 ◽

Vol 50 (3) ◽

pp. 376-384.e2 ◽

Cited By ~ 10

Author(s):

Sharon S. Lee ◽

YoonSun Choi ◽

Glenn S. Pransky

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Opioid Prescribing ◽

Occupational Low Back Pain

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Effect of opioid analgesics on emergency department length of stay among low back pain patients in the United States

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2020.06.002 ◽

2020 ◽

Vol 38 (9) ◽

pp. 1802-1806

Author(s):

Seth W. Anderson ◽

Sandipan Bhattacharjee ◽

Asad E. Patanwala

Keyword(s):

United States ◽

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Length Of Stay ◽

Opioid Analgesics ◽

The United States ◽

Low Back ◽

Pain Patients

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Prevalence of Hospital Admissions for Low Back Pain: Protocol for a Systematic Review and Meta-Analysis

10.31219/osf.io/ym9ka ◽

2020 ◽

Author(s):

Harrison J Lord ◽

Danielle Coombs ◽

Christopher Maher ◽

Gustavo C Machado

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Length Of Stay ◽

Hospital Admission ◽

Hospital Admissions ◽

Functional Decline ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Low Back

Low back pain is the leading cause of years lived with disability in most countries and creates a huge burden for healthcare systems globally. Around the globe, 4.4% of all emergency department attendances are attributed to low back pain, and subsequent admissions to hospital seem to be common. These hospitalisations can result in unnecessary medical care, functional decline and high costs. There are no systematic reviews summarising the global prevalence of hospital admission for low back pain, identifying the sources of admissions or estimating hospital length of stay. This information would be valuable for health and medical researchers, front-line clinicians, and health planners aiming to improve and increase the value of their health services. The objectives of this study are to estimate the prevalence of hospital admission for low back pain from different healthcare facilities across the globe, including the emergency department, as well as investigate hospital length of stay and explore sources of heterogeneity when categorising studies according to low back pain definitions, sources of admission, study period, study setting and country’s region and income level.

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Efficacy and Safety of Acupuncture for Acute Low Back Pain in Emergency Department: A Pilot Cohort Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/179731 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Yen-Ting Liu ◽

Chih-Wen Chiu ◽

Chin-Fu Chang ◽

Tsung-Chieh Lee ◽

Chia-Yun Chen ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Control Group ◽

Low Back ◽

Efficacy And Safety ◽

Acute Low Back Pain ◽

Significant Difference ◽

Experimental Group

Introduction. Low back pain (LBP) is one of the most common complaints in the emergency department (ED). There are several research articles providing evidence for acupuncture for treating chronic LBP but few about treating acute LBP. This study assessed the efficacy and safety of acupuncture for the treatment of acute LBP in the ED.Materials and methods. A clinical pilot cohort study was conducted. 60 participants, recruited in the ED, were divided into experimental and control groups with 1 dropout during the study. Life-threatening conditions or severe neurological defects were excluded. The experimental group (n=45) received a series of fixed points of acupuncture. The control group (n=14) received sham acupuncture by pasting seed-patches near acupoints. Back pain was measured using the visual analog scale (VAS) at three time points: baseline and immediately after and 3 days after intervention as the primary outcome. The secondary outcomes were heart rate variability (HRV) and adverse events.Results. The VAS demonstrated a significant decrease (Pvalue <0.001) for the experimental group after 15 minutes of acupuncture. The variation in HRV showed no significant difference in either group. No adverse event was reported.Conclusion. Acupuncture might provide immediate effect in reducing the pain of acute LBP safely.

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