The Management of Sickle Cell Pain in the Emergency Department

Po, Chiara; Colombatti, Raffaella; Cirigliano, Amelia; Dalt, Liviana Da; Agosto, Caterina; Benini, Franca; Zanconato, Stefania; Sainati, Laura

doi:10.1097/ajp.0b013e318245764b

Cited by 22 publications

(18 citation statements)

References 21 publications

(22 reference statements)

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“…The number of patients with SCD has dramatically increased in Italy in the past decade due to immigration, 1,2 and health care providers have had to address clinical issues related to acute and chronic management of patients. [3][4][5] One of the first steps of the Italian Association of Pediatric Hematology Oncology (AIEOP) Red Cell Disorder Working Group in 2008 was the organization of a National Network for Pediatric SCD and the development of National Guidelines for the Management of SCD in children in Italy. Nevertheless, the implementation of minimal standards of care needs time and the dissemination of knowledge and best practices regarding SCD in centers that have historically been dedicated to thalassemia patients may not be immediate.…”

Section: Introductionmentioning

confidence: 99%

Hydroxyurea prescription, availability and use for children with sickle cell disease in Italy: Results of a National Multicenter survey

Colombatti

Palazzi²,

Masera

et al. 2017

Pediatric Blood & Cancer

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Section: Introductionmentioning

confidence: 99%

Hydroxyurea prescription, availability and use for children with sickle cell disease in Italy: Results of a National Multicenter survey

Colombatti

Palazzi²,

Masera

et al. 2017

Pediatric Blood & Cancer

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“…This increases the risks for infections and other health complications that require emergency intervention [15–17]. In particular, high rates of ED utilization have been reported in single and multi-institutional studies [4, 6, 7, 11, 18–24]. The predictors of frequent ED utilization are not fully understood [20], but the following variables have been found to be associated with higher ED and hospital utilization: (1) the more severe disease and disease-related complications, (2) the need for pain crisis management [25], (3) higher white blood cell counts, (4) lower hemoglobin levels, (5) asthma, (6) being publically insured, (7) being 18 to 30 years old, and (8) the inability to obtain follow-up appointments with hematology.…”

Section: Introductionmentioning

confidence: 99%

Saudi SCD patients’ symptoms and quality of life relative to the number of ED visits

et al. 2016

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BackgroundIndividuals living with sickle cell disease (SCD) have significantly increased emergency department (ED) use compared to the general population. In Saudi Arabia, health care is free for all individuals and therefore has no bearing on increased ED visits. However, little is known about the relationship between quality of life (QoL) and frequency of acute care utilization in this patient population.MethodsA cross-sectional study was conducted on 366 patients with SCD who attended the outpatient department at King Fahad Hospital, Hofuf, Saudi Arabia. Data were collected through self-administered surveys, which included: demographics, SCD-related ED visits, clinical issues, and QoL levels. We assessed the ED use by asking for the number of SCD-related ED visits within a 6-month period.ResultsThe self-report survey of ED visits was completed by 308 SCD patients. The median number of SCD-related ED visits within a 6-month time period (IQR) was four (2-7 visits). According to the unadjusted negative binomial model, the rate of SCD-related ED visits increased by (46, 39.3, 40, and 53.5 %) for patients with fever, skin redness with itching, swelling, and blood transfusion, respectively. Poor QoL tends to increase the rate of SCD-related ED visits. Well education and poor general health positively influenced the rate of SCD-related ED visits. Well education tends to increase the rate of SCD-related ED visits by 50.2 %. The rate of SCD-related ED visits decreased by 1.4 % for every point increase in general health.ConclusionSaudi patients with sickle cell disease reported a wide range of SCD-related ED visits. It was estimated that six of 10 SCD patients had at least three ED visits within a 6-month period. Well education and poor general health resulted in an increase in the rate of SCD-related ED visits.

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“…This is high, as a large multistate study found that about 30% of patients with SCD did not require hospitalization in the span of a year (Brousseau et al, 2010). When patients with SCD present to the ED, about half require hospitalization (Po' et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Attitudes Among Healthcare Providers and Patients Diagnosed With Sickle Cell Disease

O’Connor¹,

Hanes

Lindsey

et al. 2014

Clinical Journal of Oncology Nursing

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Sickle cell disease (SCD) is a chronic condition that affects thousands of people worldwide. The purpose of this study is to illustrate some of the challenges and perceptions of people diagnosed with SCD. The aims were to describe stressors, problematic symptoms, sources of support, and interactions with healthcare providers. This descriptive study, using mostly open-ended questions and conceptual analysis, included a sample of patients with SCD who were older than 18 years in ambulatory (57%) and inpatient (43%) clinics. Participants completed a 20-minute interview. Pain or SCD crisis were the chief reasons for hospitalization, and a wellness checkup was the chief reason people returned to an ambulatory clinic. Most (74%) were able to perform chores. Family was reported to cause the most stress in the home and also provide the most help. Pain is a pervasive aspect of life, limiting activities of daily living. Negative interactions with healthcare providers are common; therefore, advocacy is necessary for patients with SCD.

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The Management of Sickle Cell Pain in the Emergency Department

Cited by 22 publications

References 21 publications

Hydroxyurea prescription, availability and use for children with sickle cell disease in Italy: Results of a National Multicenter survey

Hydroxyurea prescription, availability and use for children with sickle cell disease in Italy: Results of a National Multicenter survey

Saudi SCD patients’ symptoms and quality of life relative to the number of ED visits

Attitudes Among Healthcare Providers and Patients Diagnosed With Sickle Cell Disease

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