Factors predictive of leg-ulcer healing in sickle cell disease: a multicentre, prospective cohort study

Senet, Patricia; Blas-Châtelain, C.; Lévy, Pierre; Manea, E.; Peschanski, Marc; Mirault, Tristan; Stankovic‐Stojanovic, Katia; Debure, C.; Debbache, Karima; Girot, Robert; Bureau, J.-M.; Bachmeyer, Claude; Baldeschi, Christine; Galactéros, Frédéric; Lionnet, François; Gellen-Dautremer, Justine

doi:10.1111/bjd.15241

Cited by 26 publications

(43 citation statements)

References 38 publications

(71 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our analysis identified that duration over 90 days and wound area >10 cm 2 are predictors of poor outcome for sickle cell ulcers. This is consistent with previous studies, which were conducted within highvolume sickle cell disease referral centers, 7,12 and confirms that these findings are applicable to a broader population treated in wound healing centers. Our findings confirmed a significant age difference between patients with sickle cell ulcers and those with venous ulcers, 42.2 years versus 70.7 years, respectively.…”

Section: Discussionsupporting

confidence: 93%

“…Although the data set did include frequency of visits and of debridements, additional data on treatment approaches for sickle cell ulcers-such as topical treatments, compression therapy, human skin equivalents, skin grafts, transfusion therapy, nutritional support, antibiot-ics, or pentoxifylline-were not available. 9,12 The analysis focused on healing within individual care episodes, and could not discern between wound recurrence and wound persistence. Finally, the analysis does not clarify to what degree larger area and longer duration at presentation are markers for intrinsically poorer healing processes in the patient, as opposed to markers of poor or delayed initiation of care that leads to worse healing prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of large data sets relied on cohorts of patients who were referred to highvolume specialist centers, and may not represent the epidemiology or disease course of sickle cell ulcers treated in diverse settings. 7,12 As information systems evolve across the health delivery system, large clinical databases used by networks of clinical providers can be a promising tool for the study of disease entities that are relatively rare at any single treatment center. 13,14 In this study, we leveraged a clinical information system used by a national network of wound healing centers in the United States to describe the characteristics of sickle cell ulcers in this broad population; examine the effect of clinical characteristics on healing prognosis; and identify healing patterns of sickle cell ulcers as distinct from those of venous ulcers, which are the most common type of lower limb wound.…”

Section: Clinical Problem Addressedmentioning

confidence: 99%

See 2 more Smart Citations

Use of a National Electronic Health Record Network to Describe Characteristics and Healing Patterns of Sickle Cell Ulcers

Flattau

Gordon²,

Vinces

et al. 2018

Advances in Wound Care

View full text Add to dashboard Cite

Sickle cell ulcers affect as many as 15% of patients with sickle cell disease in the United States and severely impact quality of life. An understanding of baseline healing patterns is important to inform study design for future trials that test therapies for this disease. In this study, an electronic wound management system was leveraged to analyze retrospective data on 133 unique sickle cell patients who were treated across 114 wound healing centers, and to describe their characteristics and healing patterns as compared with those of venous ulcer patients. The data included 198 care episodes for 427 wounds. Patients with sickle cell ulcers were younger and had fewer comorbid diseases than those with venous ulcers. Larger size and longer duration were predictors of poor healing. Between the first and fourth assessments, mean change in area for sickle cell ulcers showed a 58% increase, compared with a 13% decrease for venous ulcers. Kaplan-Meier curves showed poorer healing in sickle cell ulcers than in venous ulcers across all categories of size and duration. Patients with sickle cell ulcers had longer care episodes and were more likely to re-present for care. This study reports on the largest data set of sickle cell ulcer patients analyzed to date in the published literature to provide a more detailed understanding of wound healing patterns of this disease. A national network of electronic health records can effectively identify a large number of patients with sickle cell ulcers to support analysis of epidemiology, healing patterns, and health care utilization.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Problem Addressedmentioning

confidence: 99%

See 1 more Smart Citation

Use of a National Electronic Health Record Network to Describe Characteristics and Healing Patterns of Sickle Cell Ulcers

Flattau

Gordon²,

Vinces

et al. 2018

Advances in Wound Care

View full text Add to dashboard Cite

show abstract

“…The first one separates those who will never have ulcers from those who will. The second separates patients who will not be able to heal ‘quickly’ from others that Senet et al . have identified here.…”

mentioning

confidence: 85%

“…In this issue of the BJD Senet et al . have questioned the factors that may predict the course of ulcers in patients with sickle cell disease (SCD) . Through a retrospective analysis from two French referral centres, these authors found that two parameters were predictive of a poor prognosis: a duration of ulcers at inclusion longer than 9 weeks and a surface area larger than 8 cm 2 .…”

mentioning

confidence: 99%