Evidence map›Paper›PMID 34631453›Full record

ArticleWorld journal of orthopedics2021

Trends and risk factors for opioid administration for non-emergent lower back pain.

Chukwuweike U Gwam, Ahmed K Emara, Noor Chughtai, Sameer Javed, T David Luo, Kevin Y Wang, Morad Chughtai, Tadhg O'Gara, Johannes F Plate

Open access · diamondAbstract read
In one paragraph

Article in World journal of orthopedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Chukwuweike U GwamDepartment of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
Ahmed K EmaraDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
Noor ChughtaiDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
Sameer JavedDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
T David LuoDepartment of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
Kevin Y WangDepartment of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
Morad ChughtaiDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States. chughtm@ccf.org.
Tadhg O'GaraDepartment of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
Johannes F PlateDepartment of Orthopaedic Surgery, University of Pittsburgh, 5200 Centre Avenue, Suite 415, Pittsburgh, PA 15232, USA.
Cleveland Clinic · USWake Forest University · USUniversity of Pittsburgh · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-emergent low-back pain (LBP) is one of the most prevalent presenting complaints to the emergency department (ED) and has been shown to contribute to overcrowding in the ED as well as diverting attention away from more serious complaints. There has been an increasing focus in current literature regarding ED admission and opioid prescriptions for general complaints of pain, however, there is limited data concerning the trends over the last decade in ED admissions for non-emergent LBP as well as any subsequent opioid prescriptions by the ED for this complaint.

aimTo determine trends in non-emergent ED visits for back pain; annual trends in opioid administration for patients presenting to the ED for back pain; and factors associated with receiving an opioid-based medication for non-emergent LBP in the ED.

methodsPatients presenting to the ED for non-emergent LBP from 2010 to 2017 were retrospectively identified from the National Hospital Ambulatory Medical Care Survey database. The "year" variable was transformed to two-year intervals, and a weighted survey analysis was conducted utilizing the weighted variables to generate incidence estimates. Bivariate statistics were used to assess differences in count data, and logistic regression was performed to identify factors associated with patients being discharged from the ED with narcotics. Statistical significance was set to a

resultsOut of a total of 41658475 total ED visits, 3.8% (7726) met our inclusion and exclusion criteria. There was a decrease in the rates of non-emergent back pain to the ED from 4.05% of all cases during 2010 and 2011 to 3.56% during 2016 and 2017. The most common opioids prescribed over the period included hydrocodone-based medications (49.1%) and tramadol-based medications (16.9), with the combination of all other opioid types contributing to 35.7% of total opioids prescribed

conclusionFrom 2010 to 2017, there was a significant decrease in the number of non-emergent LBP ED visits, as well as a decrease in opioids prescribed at these visits. These findings may be attributed to the increased focus and regulatory guidelines on opioid prescription practices at both the federal and state levels. Since non-emergent LBP is still a highly common ED presentation, conclusions drawn from opioid prescription practices within this cohort is necessary for limiting unnecessary ED opioid prescriptions.

Indexed as

ComplicationsEmergency DepartmentLow back painOpioidsSpineTrends

Identifiers

PMID34631453
PMCPMC8472449
OpenAlexW3199749857

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.