{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:11:05Z","timestamp":1765041065919},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>\u00a0Back pain is one of the most common pain syndromes in the United States, but there has been limited recent description of the role of emergency departments (EDs) in caring for patients with back pain. We investigated trends in the evaluation and management of back pain in U.S. EDs from 2007 to 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\u00a0We performed a retrospective analysis of the National Hospital Ambulatory Medical Care Survey, a nationally representative annual survey of ED visits, which includes data on patient-, hospital-, and visit-level characteristics. We evaluated trends among adult ED visits for back pain, including demographics, resource utilization, and disposition. Trends were assessed through the use of survey-weighted analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\u00a0Visit rates as a proportion of overall ED visits were stable from 2007 to 2016 (9.1% [95% confidence interval (CI): 8.5\u20139.6] vs. 9.3% [95% CI: 8.6\u201310.0]; P\u2009=\u20090.44). Admission rates declined from 6.4% (95% CI: 5.1\u20138.0) to 5.0% (95% CI: 3.5\u20136.9; P\u2009&amp;lt;\u20090.001). Imaging utilization increased from 51.7% (95% CI: 49.3\u201354.1) to 57.6% (95% CI: 53.3\u201361.7; P\u2009=\u20090.023), with an increase of 58.3% in computed tomography. Overall opioid utilization declined from 53.5% (95% CI: 49.4\u201357.5) to 46.5% (95% CI: 43.2\u201349.8; P\u2009&amp;lt;\u20090.001). Tramadol use increased over the study period (4.1% [95% CI: 3.0\u20135.8] vs. 8.4% [95% CI: 6.6\u201310.7]; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\u00a0Opioid utilization during ED visits for back pain decreased from 2007 to 2016, whereas tramadol use more than doubled. Care intensity increased significantly despite declining admission rates. Further research into optimal strategies for back pain management in the ED is needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa385","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T12:40:35Z","timestamp":1601469635000},"page":"67-74","source":"Crossref","is-referenced-by-count":6,"title":["Trends in the Evaluation and Management of Back Pain in Emergency Departments, United States, 2007\u20132016"],"prefix":"10.1093","volume":"22","author":[{"given":"Peter M","family":"Mullins","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women\u2019s Hospital, Harvard University, Boston, Massachusetts, USA"},{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Gates","family":"Merriman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women\u2019s Hospital, Harvard University, Boston, Massachusetts, USA"},{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryann","family":"Mazer-Amirshahi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, MedStar Washington Hospital Center; Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott G","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women\u2019s Hospital, Harvard University, Boston, Massachusetts, 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