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.
Keywords
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Article Info
Publication History
Published online: June 06, 2020
Accepted:
June 3,
2020
Received in revised form:
June 1,
2020
Received:
February 14,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
