Imaging use for uncomplicated low back pain by emergency physicians according to the Smarter Medicine recommendations

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State: Public
Version: After imprimatur
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Serval ID
serval:BIB_618E60485399
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Imaging use for uncomplicated low back pain by emergency physicians according to the Smarter Medicine recommendations
Author(s)
RUSCIO K.
Director(s)
DAMI F.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2021
Language
english
Number of pages
10
Abstract
Background
Low back pain (LBP) is one of the most common causes for emergency department’s (ED) consultation. Usually, LBP is non-specific and associations such as Choosing Wisely Canada (CWC) Emergency Medicine group or Smarter Medicine Switzerland recommend avoidance of lumbosacral imaging for patients with non-traumatic LBP in the absence of red flags. The objective of this study was to determine the adherence to this recommendation in the emergency department of Lausanne University Hospital, Switzerland. The second objective was to determine the factors that may influence the decision to order imaging.
Methods
We conducted a retrospective observational study over a 1-year period between January 1st and December 31st 2019. All data were collected from patients who presented themselves to the emergency department of Lausanne University Hospital with non-complicated LBP. Patients with red flags and/or who were admitted to the hospital were excluded from the analysis.
Results
Among a total of 756 eligible patients, 372 were included. Imaging was ordered in 64 (17.20%) of them, including 55 lumbar X-ray, 5 CT-scan and 4 MRI. None of these imaging lead to diagnostic a cause of LBP. Age was the only variable positively associated with imaging (p = .001). There was no statistical difference in the other variables analyzed between these two groups.
Conclusions
In overall, Choosing Wisely recommendation seems to be respected by the emergency physicians of Lausanne University Hospital although there is a trend toward performing more imaging for older patients.
Keywords
low back pain, choosing wisely, emergency medicine, imaging, low-risk low back pain
Create date
12/09/2022 10:51
Last modification date
27/09/2023 5:59
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