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Hospitalisations for sickle-cell disease in an Australian paediatric population
Yvonne Teoh1, Anthea Greenway, Helen Savoia
1Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia. ysl.teoh@gmail.com
Insights
Sickle-cell disease (SCD) in Australian children requires significant hospitalizations for complications like vaso-occlusive crises and infections. Healthcare strategies must address multicultural needs and optimize management protocols for this growing population.
Area of Science:
- Paediatric Haematology
- Public Health
Background:
- Sickle-cell disease (SCD) prevalence is increasing in Australia due to migration.
- The demographic and hospital resource utilization of Australian paediatric SCD patients remain undescribed.
Purpose of the Study:
- To characterize the demographic profile of paediatric patients with SCD at The Royal Children's Hospital, Victoria.
- To quantify hospital resource utilization within this population.
Main Methods:
- Retrospective chart review of SCD patients (0.2–18.0 years) over a 10.5-year period.
- Descriptive analysis of patient demographics and hospital admission data.
Main Results:
- 37 paediatric SCD patients (28 homozygous SCD, 1 SCD-C, 8 SCD-beta) accounted for 535 admissions.
- Common admissions included unplanned (50%) for vaso-occlusive crisis (70.8%), infections (12.1%), and anemia (9.8%), and planned (50%) for transfusion therapy (91.9%).
- Mean length of stay for unplanned admissions was 3.2 days.
Conclusions:
- Paediatric SCD patients in Australia necessitate hospitalizations for disease-related complications and procedures.
- Optimal care requires addressing multicultural patient demographics, timely vaso-occlusive crisis management, and established SCD protocols.
Aim:
Sickle-cell disease (SCD) is more prevalent in Australia due to increased migration; however, the Australian paediatric SCD population has not been previously described. This study aimed to identify the demographic features of and quantify the hospital resource utilisation in the SCD population at The Royal Children's Hospital in Victoria.
Methods:
This was a retrospective chart review of SCD patients who presented to the Royal Children's Hospital over a 10.5-year period. Descriptive analyses were conducted.
Results:
Thirty-seven SCD patients aged from 0.2 to 18.0 years (mean: 8.5 ± 4.8 years) had 535 admissions over the 10.5-year period. The population was made up of 28 homozygous sickle-cell disease, 1 sickle C disease and 8 sickle-cell beta patients from a variety of ethnic backgrounds. Admissions included 264 unplanned admissions, that is 258 admissions via the emergency department and 6 admissions via outpatients, and 271 planned admissions. Mean length of stay for unplanned admissions was 3.2 ± 2.6 days. Common diagnoses for unplanned admissions were 187 vaso-occlusive crisis (70.8%), 32 infections (12.1%) and 26 anaemic episodes (9.8%). Transfusion therapy (91.9%) accounted for the majority of planned admissions.
Conclusions:
Children with sickle-cell disease in an Australian setting require hospitalisation for various reasons related to disease, either unexpected complications or elective procedures. Factors affecting the provision of optimal healthcare to be explored include the multicultural demographics of the SCD population, the timely management of vaso-occlusive crises and the availability of SCD-related protocols.
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