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

Abstract

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.

Gestão e monitoramento dos registros de lesões de pele com apoio das tecnologias de informação e comunicação: Uma revisão integrativa

“…A gestão eletrônica dos registros de saúde obtidos a partir das inspeções regulares das feridas permite avaliar a eficácia dos cuidados prescritos, acompanhar os resultados do tratamento, sinalizar situações de risco, identificar potenciais de infecção e analisar os indicadores de qualidade (Flattau et al, 2018). Portanto, otimiza o tempo da equipe, aprimora a qualidade da assistência, auxilia os gestores nas tomadas de decisão e redução de custos.…”

Emergency Department Utilization for Patients Living With Sickle Cell Disease: Psychosocial Predictors of Health Care Behaviors

“…[37][38][39] For example, in leg ulcers, which is a rare but significant complication of SCD, studies have shown that presenting 60 to 90 days from initial occurrence has a negative influence on healing rates. 40 An additional example includes delayed diagnosis of priapism and therapy, which can result in impotence. 41 In the ED, mortality and morbidity outcomes are often a concern with delayed presentation.…”

Colocating Wound Care for Patients with Sickle Cell Ulcers in a Hematology Clinic

“…Treatment of this orphan disease requires expertise in its pathophysiology, 4 clinical course, and treatment options. However, clinicians who treat adult patients with SCD often lack experience in SCD management, 5 and most wound healing specialists see few patients with sickle cell ulcers 6 . The unique pathophysiology and clinical presentation of sickle cell ulcers merit specific study, and effective management will likely require the development of targeted treatments.…”

“…However, clinicians who treat adult patients with SCD often lack experience in SCD management, 5 and most wound healing specialists see few patients with sickle cell ulcers. 6 The unique pathophysiology and clinical presentation of sickle cell ulcers merit specific study, and effective management will likely require the development of targeted treatments. However, as is typical with rare diseases, 7 a paucity of sites with significant concentrations of patients with sickle cell ulcers impedes scientific study.…”