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Effect of opioid analgesics on emergency department length of stay among low back pain patients in the United States.
Am J Emerg Med. 2020 09; 38(9):1802-1806.AJ

Abstract

OBJECTIVES

The objective of this study was to compare emergency department (ED) length of stay (LOS) between patients treated with opioid analgesia versus non-opioid analgesia for low back pain (LBP) in the ED.

METHODS

We conducted a secondary analysis of National Hospital Ambulatory Medical Care Survey (NHAMCS) data (2014-2015). Adults (age ≥18 years) who presented to the ED with a reason for visit or primary diagnosis of LBP were included in the final study sample. Patient visits were categorized into two groups based on whether they received opioid analgesia (with or without non-opioid analgesia) or non-opioid analgesia only in the ED. The primary outcome measure was ED LOS, which was log-transformed (as ED LOS was not normally distributed) for analysis. A multivariable linear regression analysis was used to evaluate the association between opioid use and ED LOS.

RESULTS

The study sample consisted of a national estimate of approximately 8.6 million ED visits for LBP (during 2014-2015), of which 60.1% received opioids and 39.9% received non-opioids only. The geometric mean ED LOS for patient visits who received opioids was longer than patient visits who received non-opioids (142 versus 92 min, respectively; p < 0.001). After adjusting for confounders in the multivariable analysis, patient visits that received opioids had a significantly longer ED LOS (coefficient 0.25; 95% CI 0.11 to 0.38; p < 0.001).

CONCLUSIONS

In a nationally representative sample of patient visits to ED due to LBP in the US, use of opioids in the ED was associated with an increased ED LOS.

Authors+Show Affiliations

Tucson Medical Center, Tucson, AZ, United States of America.Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, United States of America. Electronic address: bhattacharjee@pharmacy.arizona.edu.The University of Sydney School of Pharmacy, Faculty of Medicine and Health, S343, Pharmacy Building (A15), The University of Sydney, NSW 2006, Australia; Department of Pharmacy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32739851

Citation

Anderson, Seth W., et al. "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, vol. 38, no. 9, 2020, pp. 1802-1806.
Anderson SW, Bhattacharjee S, Patanwala AE. Effect of opioid analgesics on emergency department length of stay among low back pain patients in the United States. Am J Emerg Med. 2020;38(9):1802-1806.
Anderson, S. W., Bhattacharjee, S., & Patanwala, A. E. (2020). 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, 38(9), 1802-1806. https://doi.org/10.1016/j.ajem.2020.06.002
Anderson SW, Bhattacharjee S, Patanwala AE. Effect of Opioid Analgesics On Emergency Department Length of Stay Among Low Back Pain Patients in the United States. Am J Emerg Med. 2020;38(9):1802-1806. PubMed PMID: 32739851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of opioid analgesics on emergency department length of stay among low back pain patients in the United States. AU - Anderson,Seth W, AU - Bhattacharjee,Sandipan, AU - Patanwala,Asad E, Y1 - 2020/06/06/ PY - 2020/02/14/received PY - 2020/06/01/revised PY - 2020/06/03/accepted PY - 2020/8/3/pubmed PY - 2020/11/3/medline PY - 2020/8/3/entrez KW - Emergency department KW - Length of stay KW - Non-opioid KW - Opioid SP - 1802 EP - 1806 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 38 IS - 9 N2 - OBJECTIVES: The objective of this study was to compare emergency department (ED) length of stay (LOS) between patients treated with opioid analgesia versus non-opioid analgesia for low back pain (LBP) in the ED. METHODS: We conducted a secondary analysis of National Hospital Ambulatory Medical Care Survey (NHAMCS) data (2014-2015). Adults (age ≥18 years) who presented to the ED with a reason for visit or primary diagnosis of LBP were included in the final study sample. Patient visits were categorized into two groups based on whether they received opioid analgesia (with or without non-opioid analgesia) or non-opioid analgesia only in the ED. The primary outcome measure was ED LOS, which was log-transformed (as ED LOS was not normally distributed) for analysis. A multivariable linear regression analysis was used to evaluate the association between opioid use and ED LOS. RESULTS: The study sample consisted of a national estimate of approximately 8.6 million ED visits for LBP (during 2014-2015), of which 60.1% received opioids and 39.9% received non-opioids only. The geometric mean ED LOS for patient visits who received opioids was longer than patient visits who received non-opioids (142 versus 92 min, respectively; p < 0.001). After adjusting for confounders in the multivariable analysis, patient visits that received opioids had a significantly longer ED LOS (coefficient 0.25; 95% CI 0.11 to 0.38; p < 0.001). CONCLUSIONS: In a nationally representative sample of patient visits to ED due to LBP in the US, use of opioids in the ED was associated with an increased ED LOS. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/32739851/Effect_of_opioid_analgesics_on_emergency_department_length_of_stay_among_low_back_pain_patients_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(20)30478-2 DB - PRIME DP - Unbound Medicine ER -