Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Apr 21;13(4):e069517.
doi: 10.1136/bmjopen-2022-069517.

Global prevalence of hospital admissions for low back pain: a systematic review with meta-analysis

Alla Melman  1 , Harrison J Lord  2 , Danielle Coombs  3 , Joshua Zadro  3 , Christopher G Maher  3 , Gustavo C Machado  3
Affiliations
Meta-Analysis

Global prevalence of hospital admissions for low back pain: a systematic review with meta-analysis

Alla Melman et al. BMJ Open. .

Abstract

Objectives: To determine the proportion of low back pain presentations that are admitted to hospital from the emergency department (ED), the proportion of hospital admissions due to a primary diagnosis of low back pain and the mean hospital length of stay (LOS), globally.

Methods: We searched MEDLINE, CINAHL, EMBASE, Web of Science, PsycINFO and LILACS from inception to July 2022. Secondary data were retrieved from publicly available government agency publications and international databases. Studies investigating admitted patients aged >18 years with a primary diagnosis of musculoskeletal low back pain and/or lumbosacral radicular pain were included.

Results: There was high heterogeneity in admission rates for low back pain from the ED, with a median of 9.6% (IQR 3.3-25.2; 9 countries). The median percentage of all hospital admissions that were due to low back pain was 0.9% (IQR 0.6-1.5; 30 countries). The median hospital LOS across 39 countries was 6.2 days for 'dorsalgia' (IQR 4.4-8.6) and 5.4 days for 'intervertebral disc disorders' (IQR 4.1-8.4). Low back pain admissions per 100 000 population had a median of 159.1 (IQR 82.6-313.8). The overall quality of the evidence was moderate.

Conclusion: This is the first systematic review with meta-analysis summarising the global prevalence of hospital admissions and hospital LOS for low back pain. There was relatively sparse data from rural and regional regions and low-income countries, as well as high heterogeneity in the results.

Keywords: EPIDEMIOLOGY; Organisation of health services; Quality in health care.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic review and Meta-Analysis flow diagram. EU, European Union;, Organisation for Economic Co-operation and Development.
Figure 2
Figure 2
Hospital admissions as a proportion of emergency department presentations for low back pain. AIHW, Australian Institute of Health and Welfare; CIHI, Canadian Institute for Health Information; ES, Effect Size (proportion).
Figure 3
Figure 3
(A) Length of stay for dorsalgia (M54), n=39 countries. (B) Length of stay for intervertebral disc disorders (M51), n=39 countries.
Figure 4
Figure 4
Admissions per 100 000 population for ‘dorsalgia’ and ‘intervertebral disc disorders’, 2018–2019, n=39 countries. Data from Cyprus, Malta, Liechtenstein, Croatia, Montenegro, Romania and Bulgaria sourced from Eurostat 2018/2019, all other data sourced from Organisation for Economic Co-operation and Development 2018/2019. ES, Effect Size (proportion).
Figure 5
Figure 5
Admissions for ‘dorsalgia’ and ‘intervertebral disc disorders’ as a proportion of all hospital admissions for any health condition, n=30 countries. *Organisation for Economic Co-operation and Development 2018 data.
See this image and copyright information in PMC

References

    1. Buchbinder R, Underwood M, Hartvigsen J, et al. . The Lancet series call to action to reduce low value care for low back pain: an update. PAIN 2020;161 Suppl 1:S57–64. 10.1097/j.pain.0000000000001869 - DOI - PMC - PubMed
    1. Buchbinder R, van Tulder M, Öberg B, et al. . Low back pain: a call for action. Lancet 2018;391:2384–8. 10.1016/S0140-6736(18)30488-4 - DOI - PubMed
    1. Oliveira CB, Maher CG, Pinto RZ, et al. . Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 2018;27:2791–803. 10.1007/s00586-018-5673-2 - DOI - PubMed
    1. Sivasubramaniam V, Patel HC, Ozdemir BA, et al. . Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study. BMJ Open 2015;5:e009011. 10.1136/bmjopen-2015-009011 - DOI - PMC - PubMed
    1. Edwards J, Hayden J, Asbridge M, et al. . Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord 2017;18:143. 10.1186/s12891-017-1511-7 - DOI - PMC - PubMed

Publication types