Characteristics of Emergency Department Visits Made by Individuals With Sickle Cell Disease in the U.S., 1999–2020

Attell, Brandon K.; Barrett, Patricia M.; Pace, Betty S.; McLemore, Morgan L.; McGee, Blake T.; Oshe, Rewo; DiGirolamo, Ann M.; Cohen, Lindsey L.; Snyder, Angela B.

doi:10.1016/j.focus.2023.100158

Cited by 7 publications

(4 citation statements)

References 51 publications

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“…The most common cause of ED visits among our SCD pediatric patients was acute painful crises among (73.91%) of patients. This result is similar to that reported by other researchers in different countries [10,19,22]. Initially, it was believed that the change in flow characteristics and erythrocyte aggregation alone caused vaso-occlusion and pain, however, the cause of vaso-occlusion is multifactorial.…”

Section: Discussionsupporting

confidence: 91%

“…The mean age of admitted patients and male preponderance is comparable to that reported by Brown et al in Nigeria (7.3±4 years and 1.3:1, respectively) [17]. Other studies by de Medeiros Fernandes et al, in Brazil [18], and Attell et al, in the USA, also reported a male preponderance of ED-admitted SCD patients [19]. These gender-specific differences observed, partly already known in the adult, have been attributed to hormonal changes.…”

Section: Discussionsupporting

confidence: 83%

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Emergency Department Utilization by Pediatric Patients With Sickle Cell Disease in Basrah, Iraq

Marroof,

Hassan

2024

Cureus

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Background Patients with sickle cell disease (SCD) often present in the Emergency Department (ED) with acute and debilitating pain and other SCD-related complications. Objectives The objective is to analyze the causes of ED visits of pediatric patients with SCD, assess the burden of ED admission due to SCD in relation to other pediatric diseases, the treatment given, and the outcomes. Methods A prospective analytical study was conducted on children and adolescents with SCD, 1-14 years old who had been admitted to the ED at Basrah Maternity and Children Hospital over a six-month period. Patient's sociodemographic and clinical data, drug history, length of ED stay, complications, outcome, and readmissions were recorded. Results A total of 422 patients with SCD were admitted to ED during the study period representing 4.10% of the total admitted cases; 276(65.40%) of them were recruited in this study, and their mean age was 7.84 ±3.47 years. The main cause for ED admission was pain (73.91%), followed by infection (10.14%) and hemolytic crisis (6.15%). The mean duration of stay at ED was 6.11±1.87 hours. All admitted SCD patients had received analgesia; non-steroidal anti-inflammatory drugs (NSAIDs) were the commonest (80.4%), followed by acetaminophen (39.5%), and opioid narcotic (18.5%). Readmission within 30-days was reported in 82(29.71%) patients and was associated with the number of ED visits/last year (B=0.151, P=0.023), length of stay at ED (B=0.140, P=0.034) and severe disease (B=0.253, P<0.001). Conclusions Acute painful episodes were the main cause of ED admission. Although most patients with pain did receive NSAIDs, only a small percentage of them did receive opioids. About one-third of patients have been readmitted within 30 days, and readmission was associated with the number of ED visits/last year, disease severity, and length of ED stay. These findings can help in establishing local guidelines for managing such patients in the ED especially pain management.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Emergency Department Utilization by Pediatric Patients With Sickle Cell Disease in Basrah, Iraq

Marroof,

Hassan

2024

Cureus

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“…38 A recent study also found that emergency department utilization among individuals with SCD increased over time. 36 Children with SCD also had higher immunization rates on individual vaccines within the primary series than children with SCT at 24 and 35 months, except for the measles, mumps, and rubella vaccine, and the hepatitis B vaccine at 35 months, for which completion rates were similar for SCD and SCT. Moreover, the coverage of the pneumococcal vaccine at 35 months was significantly higher among children with SCD than children with SCT.…”

Section: Discussionmentioning

confidence: 91%

“…The higher immunization coverage in the primary series among children with SCD aligns with previously published findings and may be due to more frequent interaction between the SCD population and the healthcare system than for individuals without SCD, such interactions include emergency department visits and hospitalizations. 15,18,36,37 Children with SCD, in comparison with those without the condition, exhibit a higher frequency of emergency room visits and are more likely to have seen a doctor. 38 A recent study also found that emergency department utilization among individuals with SCD increased over time.…”

Section: Discussionmentioning

confidence: 99%

Immunization adherence among children with sickle cell disease and sickle cell trait: Results of a population‐based study

Shi,

Sutaria,

Lakshmanan

et al. 2024

Pediatric Blood & Cancer

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IntroductionDespite the importance of timely vaccine completion for protection from infectious disease, there is limited knowledge of the immunization adherence rates of children with sickle cell disease (SCD).MethodsThis is a retrospective cohort study comparing the immunization rates of children with SCD to those with sickle cell trait between 2008 and 2019 in Georgia. Completion rates for each vaccine and the proportion of children with up‐to‐date status at 24 and 35 months were calculated and compared between the cohorts. Chi‐square tests with odds ratios (OR) for differences and 95% confidence intervals (CIs) were reported on the overall up‐to‐date rates and rates for individual vaccines at 24 and 35 months for the two cohorts.ResultsChildren with SCD had higher up‐to‐date rates than children with sickle cell trait at 24 and 35 months. At 35 months, the overall up‐to‐date rates (OR = 1.17; 95% CI, 1.04‐1.31; p = .004) and the four‐dose pneumococcal conjugate vaccine series (OR = 1.36; 95% CI, 1.18‐1.57; p < .001) were significantly different between the groups. Both cohorts had the highest completion rates for the hepatitis B series and the lowest rates for the varicella vaccine. Doses of diphtheria, tetanus, and acellular pertussis vaccine; varicella; and pneumococcal conjugate vaccines were most commonly missed by children in both cohorts.ConclusionsChildren with SCD have better immunization coverage than children with sickle cell trait, but there is an opportunity for improvement. Policymakers and healthcare professionals should focus on increasing access to care coordination services among children with SCD to ensure on‐time and preventive healthcare services.

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Comparison of Measures of Pain Intensity During Sickle Cell Disease Vaso-Occlusive Episodes

Knisely,

Barnhart,

Ibemere

et al. 2024

The Journal of Pain

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Characteristics of Emergency Department Visits Made by Individuals With Sickle Cell Disease in the U.S., 1999–2020

Cited by 7 publications

References 51 publications

Emergency Department Utilization by Pediatric Patients With Sickle Cell Disease in Basrah, Iraq

Emergency Department Utilization by Pediatric Patients With Sickle Cell Disease in Basrah, Iraq

Immunization adherence among children with sickle cell disease and sickle cell trait: Results of a population‐based study

Comparison of Measures of Pain Intensity During Sickle Cell Disease Vaso-Occlusive Episodes

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