Management and Clinical Outcomes of Community-Dwelling Older Adults with Low Back Pain: A Retrospective Cohort Study

Purpose: In older people with back pain discharged from hospital, to identify the rate of, and factors associated with, early hospital readmission at 7 and 30 days, and whether geriatrician-led home visit was associated with reduced frequency of unplanned readmission. Methods: We performed a retrospective study of geriatric medicine patients aged ≥ 65 admitted over a 12-month period with back pain. Results: Amongst 220 patients with back pain, the most common discharge diagnoses were vertebral fracture (36%, 79/220) and osteoarthritis (25%, 55/220). Twenty-five patients (11%) received a geriatrician-led post-discharge home visit and the remaining 195 patients received usual care through their general practitioner. Sixteen patients (7%) were readmitted within 7 days of discharge, all in the cohort who did not receive a home visit, and 52/20 (24%) were readmitted by day 30. On univariate analysis, infection causing back pain (OR 29.00, p = 0.01) and referral for Transitional Aged Care Program (TACP) (OR 3.67, p = 0.04) were both associated with 7-day readmission. On multivariate analysis, only infection as cause of back pain (OR 24.61, p = 0.01) maintained an independent association with odds of 7-day readmission. Geriatrician home visit was not associated with 7-day (OR > 100, 95% CI 0–>100, p = 0.23) or 30-day (OR 0.97, 95% CI 0.31–3.02, p = 0.96), readmission. Conclusion: In this retrospective study with limited numbers, early readmission was common, but a geriatrician-led model with home visit post-hospital discharge was not associated with reduced early hospital readmission. Other models beyond doctor-led interventions require consideration.