Chad Cook1, Amy Cook, Teddy Worrell. 1. Department of Surgery, Center for Excellence in Surgical Outcomes, Durham, NC, USA. chad.cook@duke.edu
Abstract
OBJECTIVE: The purpose of this study was to compare outcomes, complications, and hospital disposition in a cohort of patients hospitalized for low back pain who receive physical therapist (PT)-administered manual therapy (mobilization and manipulation) vs those who do not receive manual therapy. METHODS: The study was a retrospective data collection that used the Nationwide Inpatient Sample. Seventy-five patients hospitalized with low back pain who receive PT-administered manual therapy were matched using specific covariates with patients with low back who did not receive manual therapy. Bivariate analyses and regression modeling were used to determine comparisons between the 2 groups. RESULTS: Findings indicated that patients who received PT manual therapy had significantly longer lengths of hospital stay (P < .01) and had significantly higher inflation-adjusted costs of care (P < .01). After regression modeling and adjustments for covariates, findings for length of stay were still higher in the PT manual therapy group (P < .01), but costs were significantly lower for this group (P < .01). There were minimal findings of complications. CONCLUSIONS: Of 106 340 patients admitted for low back pain originally queried, only 75 patients (0.07%) received manual therapy, a markedly small number of patients. Outcomes may be reflective of the low effect size of manual therapy in a hospital setting or the inability to control for referral and hospital care patterns, thus disallowing appropriate matching.
OBJECTIVE: The purpose of this study was to compare outcomes, complications, and hospital disposition in a cohort of patients hospitalized for low back pain who receive physical therapist (PT)-administered manual therapy (mobilization and manipulation) vs those who do not receive manual therapy. METHODS: The study was a retrospective data collection that used the Nationwide Inpatient Sample. Seventy-five patients hospitalized with low back pain who receive PT-administered manual therapy were matched using specific covariates with patients with low back who did not receive manual therapy. Bivariate analyses and regression modeling were used to determine comparisons between the 2 groups. RESULTS: Findings indicated that patients who received PT manual therapy had significantly longer lengths of hospital stay (P < .01) and had significantly higher inflation-adjusted costs of care (P < .01). After regression modeling and adjustments for covariates, findings for length of stay were still higher in the PT manual therapy group (P < .01), but costs were significantly lower for this group (P < .01). There were minimal findings of complications. CONCLUSIONS: Of 106 340 patients admitted for low back pain originally queried, only 75 patients (0.07%) received manual therapy, a markedly small number of patients. Outcomes may be reflective of the low effect size of manual therapy in a hospital setting or the inability to control for referral and hospital care patterns, thus disallowing appropriate matching.
Authors: Andrea D Furlan; Fatemeh Yazdi; Alexander Tsertsvadze; Anita Gross; Maurits Van Tulder; Lina Santaguida; Joel Gagnier; Carlo Ammendolia; Trish Dryden; Steve Doucette; Becky Skidmore; Raymond Daniel; Thomas Ostermann; Sophia Tsouros Journal: Evid Based Complement Alternat Med Date: 2011-11-24 Impact factor: 2.629