Rogovik Alex L, Li Ying, Kirby Melanie A, Friedman Jeremy N, Goldman Ran D
Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, ON M5G1X8, Canada.
Am J Emerg Med. 2009 Sep;27(7):797-801. doi: 10.1016/j.ajem.2008.06.022.
To identify demographic, clinical, and laboratory characteristics associated with admission and a longer length of stay (LOS) due to vasoocclusive crisis (VOC) in children with sickle cell disease (SCD).
Retrospective chart review at a large tertiary pediatric center. Patients younger than 18 years with VOC due to SCD presenting to the emergency department were included. We performed multivariate regression analyses to predict characteristics associated with admission and LOS of 4 days or more.
A total of 428 visits for VOC were documented in 2005 to 2006. In a multivariate regression analysis higher pain score at triage (P < .001), older age (P = .04), and increased systolic blood pressure (P = .02) were predictors of admission. Higher pain score at triage (P = .046), older age (P = .002), increased polymorphonuclear count (P = .02), and homozygous SCD type (P = .03) were associated with prolonged hospital LOS.
These characteristics will help healthcare providers predict and plan admission and management of children with SCD.
确定与镰状细胞病(SCD)患儿因血管闭塞性危机(VOC)入院及住院时间延长相关的人口统计学、临床和实验室特征。
在一家大型三级儿科中心进行回顾性病历审查。纳入因SCD导致VOC且年龄小于18岁并到急诊科就诊的患者。我们进行多因素回归分析以预测与入院及住院4天或更长时间相关的特征。
2005年至2006年共记录了428次VOC就诊。在多因素回归分析中,分诊时疼痛评分较高(P <.001)、年龄较大(P =.04)和收缩压升高(P =.02)是入院的预测因素。分诊时疼痛评分较高(P =.046)、年龄较大(P =.002)、多形核细胞计数增加(P =.02)和纯合子SCD类型(P =.03)与住院时间延长相关。
这些特征将有助于医疗保健提供者预测和规划SCD患儿的入院及管理。