Variation in hospital admission of sickle cell patients from the emergency department using the Pediatric Health Information System

Jacob, Seethal A.; Mueller, Emily L.; Cochrane, Anneli R; Carroll, Aaron E.; Bennett, William E.

doi:10.1002/pbc.28067

Cited by 8 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This admission rate is less than a retrospective review conducted by Jacob et al which reported admission rates ranging from 50% to 60% among SCD patients with VOC. 16 In addition, another retrospective study carried on by Cheng et al) reported an admissions rate of 53%. 17 These findings indicate that a significant proportion of SCD patients presenting with VOC require hospitalization for adequate management and support the results of previous literature in terms of the need for standardized pain management plans, as studied by (Givens et al, Ender et al and Kavanagh et al).…”

Section: Discussionmentioning

confidence: 96%

Management of sickle cell disease patients presenting to the emergency department with vaso-occlusive crisis: a retrospective study

Al Hussaini,

Al Kanhal,

Al Ebrahaimi

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

Background: Sickle cell anemia (SCA) is a hereditary disease of the hemoglobin, characterized by recurring vaso-occlusive crises (VOC) leading to severe pain. VOCs constitute the primary cause for emergency department (ED) visits among sicklers. Frequent VOC episodes are associated with greater mortality. This study aimed to evaluate pain treatment trends regarding admission, discharge, length of stay in the ED, and early ED revisits among SCA patients. Methods: A cross-sectional study was conducted from January 2020 to January 2023 at the ED of King Abdulaziz medical city in Riyadh. SCA patients who presented with VOC episodes were included in this study. Demographic and clinical data of each patient were retrieved from the electronic medical file. Results: Total of 144 patients were included in the analysis. Out of the total population, 34% were admitted to hospital. Compared to those patients who were not admitted, the number of VOC was more among patients who had been admitted. Around 34% had ED revisit within 30 days and those patients had higher frequency of VOC attacks compared to those who did not revisit the ED. Only 45% of the population received appropriate dosing, 30% received an insufficient dose, and 25% received over the appropriate dose. Receiving the correct dose of morphine reduced the likelihood of ED revisits within 30 days. Conclusions: This study explores trends in VOC among sticklers, highlighting that adequate analgesia is associated with better outcomes. Addressing these variables may lead to improved care and better outcomes for SCA patients.

show abstract

Section: Discussionmentioning

confidence: 96%

Management of sickle cell disease patients presenting to the emergency department with vaso-occlusive crisis: a retrospective study

Al Hussaini,

Al Kanhal,

Al Ebrahaimi

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…In the absence of access to data from a surveillance system such as SCDC, single administrative databases can be useful for identifying trends and health outcomes among subpopulations of people with SCD. [31][32][33][34][35][36] These databases are often straightforward to access and, thus, can rapidly accelerate health services research. Such administrative databases can include discharge data only (eg, Healthcare Cost and Utilization Project, National Inpatient Sample, Pediatric Health Information System) or rely on Medicaid administrative claims (eg, state-specific Medicaid data or Transformed Medical Statistical Information Systems national Medicaid data).…”

Section: Practice Implicationsmentioning

confidence: 99%

Case Ascertainment of Sickle Cell Disease Using Surveillance or Single Administrative Database Case Definitions

et al. 2023

View full text Add to dashboard Cite

Objective: In the absence of access to surveillance system data, single-source administrative databases are often used to study health care utilization and health outcomes among people with sickle cell disease (SCD). We compared the case definitions from single-source administrative databases with a surveillance case definition to identify people with SCD. Materials and Methods: We used data from Sickle Cell Data Collection programs in California and Georgia (2016-2018). The surveillance case definition for SCD developed for the Sickle Cell Data Collection programs uses multiple databases, including newborn screening, discharge databases, state Medicaid programs, vital records, and clinic data. Case definitions for SCD in single-source administrative databases varied by database (Medicaid and discharge) and years of data (1, 2, and 3 years). We calculated the proportion of people meeting the surveillance case definition for SCD that was captured by each single administrative database case definition for SCD, by birth cohort, sex, and Medicaid enrollment. Results: In California, 7117 people met the surveillance case definition of SCD from 2016 through 2018; 48% of this group was captured by the Medicaid case definition and 41% by the discharge case definition. In Georgia, 10 448 people met the surveillance case definition of SCD from 2016 through 2018; 45% of this group was captured by the Medicaid case definition and 51% by the discharge case definition. These proportions differed by years of data, birth cohort, and length of Medicaid enrollment. Practice Implications: The surveillance case definition identified twice as many people with SCD as the single-source administrative database definitions during the same period, but trade-offs exist in using single administrative databases for decisions on policy and program expansion for SCD.

show abstract

“…Adolescence is associated with an increasing frequency of complications in SCD, particularly pain. 13 Children aged 15 to 18 years with SCD make up the largest group of children admitted for pain, 12 and approximately 40% of children aged 16 to 18 years have at least 1 episode of health care utilization for pain over a 1-year period. 13 The period around adolescence is associated with sex differences in pain 21,22 in other painful conditions, but sex differences in acute pain during adolescence are not well described in SCD.…”

Section: Introductionmentioning

confidence: 99%

Sex and frequency of pain episodes are associated with acute pain trajectories in adolescents with sickle cell disease

Astles

Liu

Gillespie

et al. 2023

PR9

View full text Add to dashboard Cite

Introduction/Objective: Acute pain episodes are a major cause of health care utilization (HCU) in sickle cell disease (SCD), and adolescence is associated with increased pain frequency. We sought to determine whether there were differences in acute pain trajectories by sex and frequency of pain episodes among adolescents with SCD who presented to the emergency department (ED). Methods: Retrospective review of electronic health records from a large, multicampus, pediatric SCD program. Results: Of the 113 adolescents included, the mean age was 16.6 (SD 0.9), 41.6% (n = 47) were female, 77.9% (n = 88) had HbSS or a similarly severe genotype, and 43.4% (n = 49) had ≥3 episodes of HCU for pain, which we defined as having history of high HCU for pain. Those with a history of high HCU for pain had higher mean pain intensity scores at presentation, were more likely to receive either intravenous or intranasal opioids, and were more likely to be hospitalized. In a model considering the 3-way interaction between sex, history of high HCU for pain, and follow-up time from the initial pain intensity score, adjusted for opioid per kilogram body weight, and prescription of hydroxyurea, adolescent female patients with high HCU for pain had the slowest decline in pain intensity during treatment for acute pain in the ED. Conclusion: Sex and history of high HCU for pain are associated with acute pain trajectories in adolescents with SCD presenting to the ED. These novel findings should be confirmed in future prospective studies.

show abstract

Variation in hospital admission of sickle cell patients from the emergency department using the Pediatric Health Information System

Cited by 8 publications

References 19 publications

Management of sickle cell disease patients presenting to the emergency department with vaso-occlusive crisis: a retrospective study

Management of sickle cell disease patients presenting to the emergency department with vaso-occlusive crisis: a retrospective study

Case Ascertainment of Sickle Cell Disease Using Surveillance or Single Administrative Database Case Definitions

Sex and frequency of pain episodes are associated with acute pain trajectories in adolescents with sickle cell disease

Contact Info

Product

Resources

About