Evaluation of Guideline-Recommended Pain Management in Acute Sickle Cell Crisis and Its Effect on Patient Outcomes

Seaser, John; Thomson, Julie; Brunsman, Allison; Patel, Nisha

doi:10.1080/15360288.2022.2084209

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…The institutionalization of a healthcare center dedicated to providing personalized care for patients with SCD is one of these recently developed methods. A sickle cell infusion clinic (SCIC), affiliated with the Johns Hopkins Hospital, showed a significant reduction in hospital admission rates from the ED when compared to the year prior to institutionalization and the year after [11][12][13]. The ESCAPED trial is an ongoing multi-center prospective cohort study, which has so far shown a substantial reduction in hospitalizations for those who were treated in SCICs compared to those who were treated in the ED (relative risk reduction (RRR) of 75%, p < 0.001) [14].…”

Section: Discussionmentioning

confidence: 99%

Early Administration of Intravenous Hydration and Opioid Analgesics Is Correlated with Decreased Admission Rates during Vaso-Occlusive Episodes in Sickle Cell Disease

Joung,

Miles,

Al-Manaseer

et al. 2024

JCM

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Background: Painful vaso-occlusive episodes (VOEs) are the hallmark of sickle cell disease (SCD) and account for frequent visits to the emergency department (ED) or urgent care (UC). Currently, the early administration of analgesics is recommended as initial management; however, there is a need for further understanding of the effect of prompt analgesics and hydration during VOEs. The objective of this study is to analyze the factors associated with the rate of hospital admission in the setting of time to intravenous (IV) analgesics and hydration. Method: This retrospective single-institution study reviewed adult and pediatric patients with SCD who presented with VOEs from January 2018 to August 2023. Results: Of 303 patient encounters, the rates of admission for the overall group, the subgroup which received IV hydration within 60 min of arrival, and the subgroup which received both IV analgesics and hydration within 60 min were 51.8%, 25.6% (RR = 0.46), and 18.2% (RR = 0.33), respectively. Further, factors such as gender and the use of hydroxyurea were found to be significantly associated with the rate of admission. Conclusions: This signifies the importance of standardizing the management of VOEs through the timely administration of IV analgesics and hydration in both adult and pediatric ED/UC.

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