Impact of early analgesia on hospitalization outcomes for sickle cell pain crisis

Pediatric Blood & Cancer
Jason PayneJeffrey D Lebensburger

Abstract

Painful events are the leading cause of hospitalizations for patients with sickle cell disease. Individualized pain plans targeting patient-specific maximum opioid dosing may shorten hospitalization length and are recommended by national guidelines. Prior to implementing individualized sickle cell pain plans, we tested the hypothesis that a shorter time to achieve a maximum opioid dose would improve hospitalization outcomes. Two-year IRB-approved, retrospective study of pediatric patients admitted for vaso-occlusive crisis (VOC). We recorded the emergency department admission time, order entry time for the maximum opioid dose during the hospitalization, and time of discharge orders.  We categorized patients as infrequent if they required <3 admissions for VOC over two years and patients as frequent if they required ≥3 admissions for VOC over two years. To account for multiple admissions, generalized linear modeling was performed. We identified 236 admissions for acute pain observed in 108 patients. Achieving an earlier maximum opioid dose was significantly associated with shorter length of hospitalization for frequent and infrequent pain patients (both P ≤ 0.0001). As total hospitalization length can be impacted by the time a m...Continue Reading

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Citations

Aug 1, 2019·Expert Review of Hematology·Carlton Dampier
Mar 23, 2020·Current Pain and Headache Reports·Jacob FiocchiOmar Viswanath
Aug 18, 2021·Journal of the American College of Emergency Physicians Open·Yves DuroseauIrina Yermilov
Aug 24, 2021·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Claire ArbitreEvelyne D Trottier
Sep 22, 2021·Journal of Translational Medicine·Tim JangSeah H Lim

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