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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
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Sickle cell disease complications: Prevalence and resource utilization.
Nirmish Shah1, Menaka Bhor2, Lin Xie3
1Department of Medicine, Duke University, Durham, NC, United States of America.
Plos One
|July 6, 2019
Summary
Sickle cell disease (SCD) patients experience frequent vaso-occlusive crisis (VOC) episodes, leading to significant emergency room visits and hospitalizations. VOC is the main driver of acute healthcare use in SCD patients.
Area of Science:
- Hematology
- Public Health
- Health Services Research
Background:
- Sickle cell disease (SCD) is a genetic blood disorder characterized by abnormal hemoglobin, leading to chronic pain and organ damage.
- Vaso-occlusive crisis (VOC) is a hallmark complication of SCD, causing severe pain and requiring significant healthcare utilization.
- Understanding the patterns and drivers of acute healthcare use in SCD is crucial for effective disease management and resource allocation.
Purpose of the Study:
- To determine the prevalence and incidence rates of vaso-occlusive crisis (VOC) episodes in adult patients with sickle cell disease (SCD).
- To differentiate between uncomplicated and complicated VOC episodes and identify associated complications.
- To ascertain the primary reasons for emergency room (ER) visits and inpatient admissions among SCD patients.
Main Methods:
- Retrospective analysis of adult SCD patients using Medicaid Analytic Extracts database (2009-2012).
- Inclusion criteria: continuous medical/pharmacy benefits for ≥6 months baseline and ≥12 months follow-up.
- Descriptive analysis of patient demographics, clinical characteristics, VOC episode rates, and reasons for ER visits/hospitalizations.
Main Results:
- 8,521 adult SCD patients with a median age of 30 years were analyzed over an average follow-up of 2.7 years.
- The overall rate of VOC episodes was 3.31 per person-year, with 2.79 episodes per patient in the first year.
- Vaso-occlusive crisis (VOC) was the primary reason for approximately 85.0% of ER visits and hospitalizations, with infectious diseases, fever, and pulmonary disorders being common complications.
Conclusions:
- Sickle cell disease (SCD) and its complications contribute to high acute healthcare utilization.
- Vaso-occlusive crisis (VOC) remains the predominant reason for emergency care and inpatient admissions in SCD patients.
- Effective management strategies targeting VOC prevention and treatment are essential for reducing healthcare burden in SCD.
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