scholarly journals Parents’ pain medication underdosing is associated with more emergency department visits in sickle cell disease

2017 ◽  
Vol 65 (4) ◽  
pp. e26906 ◽  
Author(s):  
Andrea K. Morrison ◽  
Matthew P. Myrvik ◽  
David C. Brousseau ◽  
Amy L. Drendel ◽  
J. Paul Scott ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pain Medication ◽  
Emergency Department Visits ◽  
Cell Disease

scholarly journals Emergency Department Visits Made by Patients with Sickle Cell Disease

2010 ◽  
Vol 38 (4) ◽  
pp. S536-S541 ◽  
Author(s):  
Hussain R. Yusuf ◽  
Hani K. Atrash ◽  
Scott D. Grosse ◽  
Christopher S. Parker ◽  
Althea M. Grant
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Emergency Department Visits ◽  
Cell Disease

scholarly journals Ambient air pollution and sickle cell disease-related emergency department visits in Atlanta, GA

2020 ◽  
Vol 184 ◽  
pp. 109292 ◽  
Author(s):  
Amelia H. Blumberg ◽  
Stefanie T. Ebelt ◽  
Donghai Liang ◽  
Claudia R. Morris ◽  
Jeremy A. Sarnat
Keyword(s):  
Emergency Department ◽  
Air Pollution ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Ambient Air ◽  
Emergency Department Visits ◽  
Ambient Air Pollution ◽  
Cell Disease

Asthma IN SICKLE CELL DISEASE as A RISK FACTOR for Acute Chest Syndrome IN Pediatric PATIENTS.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4610-4610
Author(s):  
Andrea P Borns ◽  
Kristy Marquez ◽  
Djesika Amendah ◽  
Alan Whiteman ◽  
Lanetta B Jordan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Conflicts Of Interest ◽  
Pulmonary Complications ◽  
Emergency Department Visits ◽  
Emergency Department Utilization ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Ann Arbor

Abstract Abstract 4610 OBJECTIVES Both asthma and sickle cell disease are major Public Health concerns. Previous studies have demonstrated that asthma among children with sickle cell disease (SCD) may increase the risk of developing acute chest syndrome (ACS), which can be life threatening. These respiratory complications may increase emergency department (ED) utilization, increase health care costs, and reduce life span among persons with SCD. The purpose of this study is to determine whether children with SCD and asthma have significantly more ED visits and if they are at higher risk of developing ACS compared to children with SCD who do not have asthma. METHODS We used MarketScan® Multi-State Medicaid Databases from Thompson Reuters (Ann Arbor, Michigan) for the years 2001 to 2005. These are proprietary datasets covering eight unidentified states. We used International Classification of Disease, 9th Division, Clinical Modifications (ICD-9-CM) codes to identify SCD, asthma and ACS. RESULTS In 2005, there were 2428 children with SCD continuously enrolled in Medicaid. Among those, 369 (15.2%) patients were identified as having asthma. The mean number of emergency department visits was significantly higher among children with both SCD and asthma compared to children with SCD without asthma (p<0.05). In addition, children with SCD and asthma were more likely to have at least one episode of ACS than children with SCD without asthma (28.2% vs. 7.8%, respectively). CONCLUSIONS Among children with SCD who are enrolled in Medicaid, asthma is a common comorbidity, which is associated with high incidence of ACS. Therefore asthma should be aggressively managed among SCD patients. Proper management of asthma may result not only in reduced pulmonary complications, but also reduced costs related to emergency department utilization and progression of lung disease into adulthood. Disclosures: No relevant conflicts of interest to declare.

Reduction in the Frequency of Emergency Department Visits for Complications Related to Sickle Hemoglobinopathies: Effects of Aggressive Hydroxyurea Therapy

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2067-2067 ◽  
Author(s):  
Ashok Raj ◽  
Arun Ranjan Panigrahi ◽  
Scott N. Myers ◽  
Jennifer Mullinax ◽  
John A Myers ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Expert Panel ◽  
Treatment Protocol ◽  
Emergency Department Visits ◽  
Cell Disease ◽  
Hb S ◽  
Ed Visits ◽  
Hydroxyurea Therapy

Abstract Context Early and aggressive use of hydroxyurea (HU) in sickle hemoglobinopathies has been in practice at our comprehensive sickle cell center since 2012 when standardized protocols were still evolving. The consensus treatment protocol for hydroxyurea therapy in sickle cell disease (SCD) documented in the "Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014" has authenticated our clinical practice. Objectives Although emergency departments play an important role in providing acute and urgent care for patients with SCD, the frequency of visits by patients can possibly be reduced by increased use of sickle-directed therapies in the outpatient setting. The objective of this study was to determine the impact of aggressive HU therapy, including shared decision making with parents for early use of HU and dose escalation up to the maximum tolerated dose, on the frequency of emergency department (ED) visits for patients with sickle hemoglobinopathies. Methods ED visits by patients with sickle hemoglobinopathies (HbSS disease, Hb S beta zero thalassemia, HbSC disease, Hb S beta plus thalassemia) were identified using ICD-9-CM diagnosis codes of 282.6, 282.60, 282.61, 282.62, 282.63, 282.64, 282.68, 282.69, 282.41, and 282.42. From visits having one or more of these diagnoses, cases that had indicated that the visit was related to an injury, poisoning, or adverse effect of medical treatment were excluded to form the study group of emergency department visits by patients. However, if the ED visit was for HU complications/side effects, they were included. Data from 2010-2015 was collected from the ED of Kosair Children's Hospital and affiliated hospitals in Louisville, which are the community-wide and primary locations where pediatric patients with sickle hemoglobinopathies are evaluated for disease-related complications requiring emergency management including pain crises, fever episodes, acute chest syndrome, etc. To determine if aggressive use of HU was associated with adecrease in the frequency of ED visits, segmented linear regression techniques were used to compare the mean monthly rates of ED visits before and after implementation of this treatment strategy. Results: The rate of sickle hemoglobinopathies seen in the ED significantly decreased after implementation of the aggressive HU treatment protocol (β=2.48 vs. β=-3.91, p=0.003). After implementation of the aggressive HU protocol, there has been a 55% decrease in the monthly rate of sickle hemoglobinopathies seen in the ED (21.0 vs. 9.5, p<0.001) from the peak monthly rate seen in 2012, which is a 40% reduction since the start of the study period [15.8 vs. 9.5, p=0.011]). Conclusion: Substantial reduction in the frequency of ED visits occurred in children with sickle hemoglobinopathies with the simple intervention of early and aggressive usage of HU and its dose escalation to the maximally tolerated dose. The findings of this study suggest that improving the process of prescribing HU as outlined in the "Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014" reduced the complications of sickle hemoglobinopathies requiring emergency care management and is an indicator of the enhanced quality of health care in sickle hemoglobinopathies. Figure 1. The average monthly rate of sickle hemoglobinopathies seen in the ED stratified by year. --- = reference point in which aggressive HU was implemented. Figure 1. The average monthly rate of sickle hemoglobinopathies seen in the ED stratified by year. --- = reference point in which aggressive HU was implemented. Disclosures No relevant conflicts of interest to declare.

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