Table 1 Individual elements extracted from the electronic health record to construct red flags
Individual elements | Serious pathologies | ||||
|---|---|---|---|---|---|
Neoplasm | Spinal fracture | Spinal infection | Inflammatory LBP | Sciatica* | |
Age ≥ 50 | ✓ | ✓ | ✓ | ✓ | |
Pain at rest | ✓ | ||||
Pain NRS (used to assess considerable pain) | ✓ | ✓ | |||
Pain minor trauma | ✓ | ||||
Diabetic | ✓ | ||||
Acute or blunt trauma | ✓ | ||||
Hx of cancer (< 15 years) | ✓ | ||||
Immunosuppressed due to condition | ✓ | ||||
Improvement with activity, worse with rest | ✓ | ||||
Known osteopenia or osteoporosis | ✓ | ||||
Steroid use (> 7.5 mg/d, > 3 mo.) | ✓ | ||||
No resp to tx or worse symptoms > 4 weeks | ✓ | ✓ | |||
Hx of spine surgery | ✓ | ||||
Morning stiffness > 30 min | ✓ | ||||
Embedded Foreign object | ✓ | ||||
IV drug abuse | ✓ | ||||
Progressive neurological deficit > 4 weeks | ✓ | ||||
Significant activity limit > 4 weeks | ✓ | ||||
Awake 2nd half night due to pain | ✓ | ||||
Fever (> 103°F/ > 38.3 °C) for 3 weeks | ✓ | ||||
Progressive or painful spinal curvature | ✓ | ||||
Unexplained weight loss (> 4.5 kg < 6 mo.) | ✓ | ||||