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Open Access 01-12-2021 | Care | Research

Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study

Authors: Emanuel Brunner, André Meichtry, Davy Vancampfort, Reinhard Imoberdorf, David Gisi, Wim Dankaerts, Anita Graf, Stefanie Wipf Rebsamen, Daniela Suter, Lukas Martin Wildi, Stefan Buechi, Cornel Sieber

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends. Delays in therapeutic procedures may result in a prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates the influence of weekday of admission and distress on LoS of inpatients with LBP.

Methods

This retrospective cohort study was conducted between 1 February 2019 and 31 January 2020. In part 1, a negative binomial model was fitted to LoS with weekday of admission as a predictor. In part 2, the same model included weekday of admission, distress level, and their interaction as covariates. Planned contrast was used in part 1 to estimate the difference in log-expected LoS between group 1 (admissions Friday/Saturday) and the reference group (admissions Sunday-Thursday). In part 2, the same contrast was used to estimate the corresponding difference in (per-unit) distress trends.

Results

We identified 173 patients with LBP. The mean LoS was 7.8 days (SD = 5.59). Patients admitted on Friday (mean LoS = 10.3) and Saturday (LoS = 10.6) had longer stays, but not those admitted on Sunday (LoS = 7.1). Analysis of the weekday effect and planned contrast showed that admission on Friday or Saturday was associated with a significant increase in LoS (log ratio = 0.42, 95% CI = 0.21 to 0.63). A total of 101 patients (58%) returned questionnaires, and complete data on distress were available from 86 patients (49%). According to the negative binomial model for LoS and the planned contrast, the distress effect on LoS was significantly influenced (difference in slopes = 0.816, 95% CI = 0.03 to 1.60) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday).

Conclusions

Delays in interdisciplinary LBP management over the weekend may prolong LoS. This may particularly affect patients reporting high levels of distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.

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Title: Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study
Authors: Emanuel Brunner
André Meichtry
Davy Vancampfort
Reinhard Imoberdorf
David Gisi
Wim Dankaerts
Anita Graf
Stefanie Wipf Rebsamen
Daniela Suter
Lukas Martin Wildi
Stefan Buechi
Cornel Sieber
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Care
Back Pain
Back Pain
Back Pain
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04529-6

At a glance: The STEP trials

Springer Medicine

Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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