Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1093/pm/pnab260 http://hdl.handle.net/11449/239911 |
Resumo: | INTRODUCTION: There is a common belief that patients presenting to emergency departments have more severe pain levels and functional limitations than those who are seen in general practice. The aim of this systematic review was to compare pain and disability levels of patients with acute low back pain presenting to general practice vs those presenting to emergency departments. METHODS: Electronic searches were conducted in MEDLINE, EMBASE, and CINAHL from database inception to February 2019. Observational studies including patients with acute non-specific low back pain presenting to emergency departments and/or general practice were eligible. Pain and/or disability scores expressed on a 0-100 scale were the primary outcomes. Risk of bias was evaluated with a validated tool for observational studies, and the overall quality of evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis with random effects and meta-regression were used to test for differences between the two settings. RESULTS: We included 12 records reporting results for 10 unique studies with a total of 6,999 participants from general practice (n = 6) and emergency departments (n = 4). There was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher pain scores than those in general practice, with a mean difference of 17.3 points (95% confidence interval: 8.8 to 25.9 on a 0-100 scale). Similarly, there was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher disability scores than those in general practice (mean difference: 21.7; 95% confidence interval: 4.6 to 38.7 on a 0-100 scale). CONCLUSION: Patients with acute non-specific low back pain presenting to emergency departments may report higher levels of pain and disability than those seen in general practice. |
id |
UNSP_12759303e3b054e4714ce4ce2532661f |
---|---|
oai_identifier_str |
oai:repositorio.unesp.br:11449/239911 |
network_acronym_str |
UNSP |
network_name_str |
Repositório Institucional da UNESP |
repository_id_str |
2946 |
spelling |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-AnalysisEvidence-Based Emergency MedicineLow Back PainPrimary Health CareINTRODUCTION: There is a common belief that patients presenting to emergency departments have more severe pain levels and functional limitations than those who are seen in general practice. The aim of this systematic review was to compare pain and disability levels of patients with acute low back pain presenting to general practice vs those presenting to emergency departments. METHODS: Electronic searches were conducted in MEDLINE, EMBASE, and CINAHL from database inception to February 2019. Observational studies including patients with acute non-specific low back pain presenting to emergency departments and/or general practice were eligible. Pain and/or disability scores expressed on a 0-100 scale were the primary outcomes. Risk of bias was evaluated with a validated tool for observational studies, and the overall quality of evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis with random effects and meta-regression were used to test for differences between the two settings. RESULTS: We included 12 records reporting results for 10 unique studies with a total of 6,999 participants from general practice (n = 6) and emergency departments (n = 4). There was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher pain scores than those in general practice, with a mean difference of 17.3 points (95% confidence interval: 8.8 to 25.9 on a 0-100 scale). Similarly, there was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher disability scores than those in general practice (mean difference: 21.7; 95% confidence interval: 4.6 to 38.7 on a 0-100 scale). CONCLUSION: Patients with acute non-specific low back pain presenting to emergency departments may report higher levels of pain and disability than those seen in general practice.National Health and Medical Research CouncilPhysical Therapy Department Faculty of Science and Technology Sao Paulo State UniversityFaculty of Medicine University of Western São Paulo (UNOESTE)Institute for Musculoskeletal HealthSchool of Public Health Faculty of Medicine and Health University of SydneyMonash Department of Clinical Epidemiology Cabrini InstituteDepartment of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash UniversityRheumatology Department Royal Prince Alfred HospitalEmergency Department Canterbury HospitalPhysical Therapy Department Faculty of Science and Technology Sao Paulo State UniversityUniversidade Estadual Paulista (UNESP)University of Western São Paulo (UNOESTE)Institute for Musculoskeletal HealthUniversity of SydneyCabrini InstituteMonash UniversityRoyal Prince Alfred HospitalCanterbury HospitalOliveira, Crystian B. [UNESP]Hamilton, MelanieTraeger, AdrianBuchbinder, RachelleRichards, BethanRogan, EileenMaher, Chris G.Machado, Gustavo C.2023-03-01T19:52:52Z2023-03-01T19:52:52Z2022-04-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article614-624http://dx.doi.org/10.1093/pm/pnab260Pain medicine (Malden, Mass.), v. 23, n. 4, p. 614-624, 2022.1526-4637http://hdl.handle.net/11449/23991110.1093/pm/pnab2602-s2.0-85128487881Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPain medicine (Malden, Mass.)info:eu-repo/semantics/openAccess2023-03-01T19:52:52Zoai:repositorio.unesp.br:11449/239911Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-03-01T19:52:52Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
title |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
spellingShingle |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis Oliveira, Crystian B. [UNESP] Evidence-Based Emergency Medicine Low Back Pain Primary Health Care |
title_short |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
title_full |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
title_fullStr |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
title_full_unstemmed |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
title_sort |
Do Patients with Acute Low Back Pain in Emergency Departments Have More Severe Symptoms than Those in General Practice? ASystematic Review with Meta-Analysis |
author |
Oliveira, Crystian B. [UNESP] |
author_facet |
Oliveira, Crystian B. [UNESP] Hamilton, Melanie Traeger, Adrian Buchbinder, Rachelle Richards, Bethan Rogan, Eileen Maher, Chris G. Machado, Gustavo C. |
author_role |
author |
author2 |
Hamilton, Melanie Traeger, Adrian Buchbinder, Rachelle Richards, Bethan Rogan, Eileen Maher, Chris G. Machado, Gustavo C. |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) University of Western São Paulo (UNOESTE) Institute for Musculoskeletal Health University of Sydney Cabrini Institute Monash University Royal Prince Alfred Hospital Canterbury Hospital |
dc.contributor.author.fl_str_mv |
Oliveira, Crystian B. [UNESP] Hamilton, Melanie Traeger, Adrian Buchbinder, Rachelle Richards, Bethan Rogan, Eileen Maher, Chris G. Machado, Gustavo C. |
dc.subject.por.fl_str_mv |
Evidence-Based Emergency Medicine Low Back Pain Primary Health Care |
topic |
Evidence-Based Emergency Medicine Low Back Pain Primary Health Care |
description |
INTRODUCTION: There is a common belief that patients presenting to emergency departments have more severe pain levels and functional limitations than those who are seen in general practice. The aim of this systematic review was to compare pain and disability levels of patients with acute low back pain presenting to general practice vs those presenting to emergency departments. METHODS: Electronic searches were conducted in MEDLINE, EMBASE, and CINAHL from database inception to February 2019. Observational studies including patients with acute non-specific low back pain presenting to emergency departments and/or general practice were eligible. Pain and/or disability scores expressed on a 0-100 scale were the primary outcomes. Risk of bias was evaluated with a validated tool for observational studies, and the overall quality of evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis with random effects and meta-regression were used to test for differences between the two settings. RESULTS: We included 12 records reporting results for 10 unique studies with a total of 6,999 participants from general practice (n = 6) and emergency departments (n = 4). There was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher pain scores than those in general practice, with a mean difference of 17.3 points (95% confidence interval: 8.8 to 25.9 on a 0-100 scale). Similarly, there was low-quality evidence (downgraded for indirectness and inconsistency) that patients presenting to emergency departments had higher disability scores than those in general practice (mean difference: 21.7; 95% confidence interval: 4.6 to 38.7 on a 0-100 scale). CONCLUSION: Patients with acute non-specific low back pain presenting to emergency departments may report higher levels of pain and disability than those seen in general practice. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-04-08 2023-03-01T19:52:52Z 2023-03-01T19:52:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1093/pm/pnab260 Pain medicine (Malden, Mass.), v. 23, n. 4, p. 614-624, 2022. 1526-4637 http://hdl.handle.net/11449/239911 10.1093/pm/pnab260 2-s2.0-85128487881 |
url |
http://dx.doi.org/10.1093/pm/pnab260 http://hdl.handle.net/11449/239911 |
identifier_str_mv |
Pain medicine (Malden, Mass.), v. 23, n. 4, p. 614-624, 2022. 1526-4637 10.1093/pm/pnab260 2-s2.0-85128487881 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Pain medicine (Malden, Mass.) |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
614-624 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1799965742024622080 |