Description of low back pain attendances in French ED

Abstract

Abstract Background Low back pain (LBP) is one of the leading contributors to disease burden worldwide [1]. In 2018, French health care insurance launched a population awareness campaign in order to promote effective behaviour change in France. Because LBP acute episodes often lead to emergency visits, Santé publique France, the French Public Health Agency and the Federation of Observatories for Emergency Medecine, performed a pre-campaign situational analysis of LBP in the French emergency department (ED) involved in the OSCOUR® network. Methods The OSCOUR network is part of the French syndromic surveillance system SurSaUD® [2] coordinated by Santé publique France since 2004. In 2017, the system collects daily individual data from about 700 ED representing 92% of the French ED attendances. Those data contain demographic, administrative and medical information including discharge diagnosis coded according ICD-10. ED attendances with a diagnosis related to LBP were analyzed from 2014 to 2017. Temporal distribution of LBP attendances, hospitalizations after discharge and stay duration in ED services were also analyzed. Results From 2014 to 2017, 504 ED were included in the analysis and LBP represented 1.12% (N = 481,291) of ED all visits. This proportion remained stable over the period. 60% of LBP attendances concerned 18 to 50 years old adults and almost 10% were hospitalized after discharge. This proportion increased with age to reach 43% for the 85 years old and more. LBP attendances were more frequent on Monday. Median stay duration were almost 3 hours but increased with age and for hospitalized patients. Conclusions The broad coverage of the ED OSCOUR® network on the whole territory and the strong partnership between epidemiologists and clinicians enable Santé publique France to produce reliable results which are also consistent with ED physician’s perception. Finally those results can be used as a reference contributing to evaluate potential benefits of this campaign. Key messages This description of low back pain ED attendances is consistent with emergency physicians perception on field and can be used as a reference to evaluate potential benefits of the prevention campaign. The national coverage of the ED OSCOUR® network and the strong partnership with emergency physicians enable Santé publique France to produce relevant description on the main causes of ED attendances.