Photo courtesy of St. Jude
Children’s Research Hospital
Population-based surveillance data has revealed patterns of emergency department (ED) visits among Californians with sickle cell disease (SCD).
Previous research suggested that between one-half and two-thirds of SCD patients’ ED visits end in a discharge from the ED, called a treat-and-release visit.
The remainder result in admission to a hospital or other treatment facility.
The purpose of the current study was to use data from the Sickle Cell Data Collection program to describe patterns of ED use for treat-and-release visits by California’s SCD population and compare these new findings with results of previous studies.
The current study was published in Pediatric Blood and Cancer.
Researchers looked at ED and hospital discharge data in California from 2005 to 2014. This included 4636 patients with SCD.
The data showed that 88% of patients had 1 or more treat-and-release ED visits during the 10-year study period.
This group of 4100 patients had 90,904 treat-and-release ED visits. The average number of visits each year was 2.1 (rage, 0-185).
In a single year (2005):
- 53% of patients had no treat-and-release ED visits (no ED use)
- 35% had between 1 and 3 visits (low ED use)
- 9% had between 4 and 10 visits (medium ED use)
- 3% had 11 or more visits (high ED use).
The youngest patients (age 0 to 9.9) and the oldest patients (80 and older) were the least likely to have at least 1 treat-and-release ED visit.
The proportion of patients with at least 1 ED visit over the study period was:
- 68% among patients age 0 to 9.9 at the close of the study
- 80% among patients age 10 to 19.9
- 92% among patients age 20 to 29.9
- 94% among patients age 30 to 39.9
- 93% among patients age 40 to 49.9
- 92% among patients age 50 to 59.9
- 92% among patients age 60 to 69.9
- 85% among patients age 70 to 79.9
- 73% among patients age 80 and older.
The researchers said this study highlights the utility of a multisource, longitudinal data collection effort for SCD. And further study of patients with the highest ED utilization may highlight areas where changes could improve and extend the lives of patients with SCD.
