Journal of osteopathic medicine · 2026
Osteopathic manipulative medicine among injured emergency department patients: a nationwide study.
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Harris Hanna, DiStefano Aviya, Bowers Kaitlin M, Nikolla Dhimitri A
Аннотация
CONTEXT: Osteopathic manipulative treatment (OMT) encompasses a wide range of diagnostic and treatment techniques for many conditions, but few studies have evaluated OMT use on injured patients.
OBJECTIVES: We aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department (ED) encounters.
METHODS: We performed a retrospective analysis of the 2018-2022 Nationwide Emergency Department Sample (NEDS) datasets. We included all ED encounters with an injury diagnosis as well as an osteopathic diagnosis or treatment, including International Classification of Diseases - Tenth Revision (ICD-10) Clinical Modification (CM) codes M9900-M9909, ICD-10 Procedure Coding System (PCS) codes 7W00X07-7W09X9Z, and Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes 98925-98929. We calculated the Injury Severity Score (ISS) and the predicted probability of injury-related in-hospital mortality for each encounter utilizing the ROCmax method. Except for counts, all statistics at the encounter level are weighted to account for the complex survey design.
RESULTS: Among 29,966,447 ED encounters with an injury diagnosis within the study period, we identified 1,686 with at least one osteopathic diagnosis or treatment code, 6.0 per 100k injury encounters (95 % confidence interval [CI] 4.2 to 8.2). A minority of encounters (574 [35.5 %]) were at level 1 or 2 trauma centers. Although 677 (39.7 %) were admitted, the median ISS was only 1 (interquartile range [IQR 1, 4]), and only 62 (2.9 %) had computed tomography (CT) orders. The predicted probability of injury-related mortality was low, 1.5 % (IQR 1.3, 2.0). Most encounters had a somatic dysfunction diagnosis without an osteopathic treatment code, 1,239 (75.9 %). The most common site of injury, as well as the body area with somatic dysfunction diagnosis and osteopathic treatment, was the thorax.
CONCLUSIONS: In this nationwide sample, few injured ED patients received OMT, the majority only received a somatic dysfunction diagnosis without osteopathic treatment, and most had minor injuries. These results offer real-world insights into the use of OMT among injured ED patients and may inform efforts to promote its adoption.
OBJECTIVES: We aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department (ED) encounters.
METHODS: We performed a retrospective analysis of the 2018-2022 Nationwide Emergency Department Sample (NEDS) datasets. We included all ED encounters with an injury diagnosis as well as an osteopathic diagnosis or treatment, including International Classification of Diseases - Tenth Revision (ICD-10) Clinical Modification (CM) codes M9900-M9909, ICD-10 Procedure Coding System (PCS) codes 7W00X07-7W09X9Z, and Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes 98925-98929. We calculated the Injury Severity Score (ISS) and the predicted probability of injury-related in-hospital mortality for each encounter utilizing the ROCmax method. Except for counts, all statistics at the encounter level are weighted to account for the complex survey design.
RESULTS: Among 29,966,447 ED encounters with an injury diagnosis within the study period, we identified 1,686 with at least one osteopathic diagnosis or treatment code, 6.0 per 100k injury encounters (95 % confidence interval [CI] 4.2 to 8.2). A minority of encounters (574 [35.5 %]) were at level 1 or 2 trauma centers. Although 677 (39.7 %) were admitted, the median ISS was only 1 (interquartile range [IQR 1, 4]), and only 62 (2.9 %) had computed tomography (CT) orders. The predicted probability of injury-related mortality was low, 1.5 % (IQR 1.3, 2.0). Most encounters had a somatic dysfunction diagnosis without an osteopathic treatment code, 1,239 (75.9 %). The most common site of injury, as well as the body area with somatic dysfunction diagnosis and osteopathic treatment, was the thorax.
CONCLUSIONS: In this nationwide sample, few injured ED patients received OMT, the majority only received a somatic dysfunction diagnosis without osteopathic treatment, and most had minor injuries. These results offer real-world insights into the use of OMT among injured ED patients and may inform efforts to promote its adoption.