Impact of a dedicated infusion clinic for acute management of adults with sickle cell pain crisis.
Impact of a dedicated infusion clinic for acute management of adults with sickle cell pain crisis.
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DOI：
10.1002/ajh.23961
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发表时间：
2015-05
影响因子：
12.8
通讯作者：
Haywood, Carlton, Jr.
中科院分区：
文献类型：
--
作者：
Lanzkron, Sophie;Carroll, C. Patrick;Hill, Peter;David, Mandy;Paul, Nicklaine;Haywood, Carlton, Jr.
大多数患有镰状细胞病（SCD）的成年人在急诊科（艾德）接受急性疼痛发作的护理。本文的目的是描述为成人SCD开设一个专门的治疗中心[镰状细胞输注诊所（SCIC）]对SCD患者结局和出院的影响。描述性数据，包括人口统计学资料，时间首次剂量的麻醉剂，疼痛评分的患者提交给SCIC和ED。马里兰州出院数据从马里兰州卫生服务成本审查委员会。采用T检验、χ 2检验和简单广义估计方程回归模型进行分析，以适当解释观察结果的聚类性质。有361名独特的患者到SCIC就诊3，874次;其中85%的患者被送回家。在同一时期，558名SCD患者到艾德就诊3,408次。这些患者从艾德的总体入院率为35.9%，但随着时间的推移显著下降，2011年12月的入院率为20%。随着时间的推移，整个巴尔的摩都会区的再入院率显著下降，再入院的可能性随着时间的推移下降了7%。SCIC模式为SCD成年人提供高质量的护理，减少了住院的需要。需要做进一步的研究来评估这种模式的成本效益。Am.血液学杂志90：376-380，2015.© 2015 Wiley Periodicals，Inc.
Most adults with sickle cell disease (SCD) receive care for their acute painful episodes in an emergency department (ED) setting. The purpose of this article is to describe the impact of opening a dedicated treatment center for adults with SCD [Sickle Cell Infusion Clinic (SCIC)] on patient outcomes and on hospital discharges for SCD. Descriptive data including demographics, time to first dose of narcotic, and pain scores were collected on patients presenting to the SCIC and ED. Maryland hospital discharge data were obtained from the Maryland Health Services Cost Review Commission. Analyses were conducted usingTtests, χ2tests, and simple generalized estimating equation regression models accounting for the clustered nature of observations, as appropriate. There were 3,874 visits to the SCIC by 361 unique patients; 85% of those visits resulted in the patient being sent home. During the same time period, there were 3,408 visits to the ED by 558 unique patients with SCD. The overall admission rate from the ED for these patients was 35.9% but decreased significantly over the time period with a rate of 20% in December 2011. There was a significant decrease in readmissions over time for the entire Baltimore Metro area with the likelihood of readmission decreasing by 7% over time. The SCIC model provides adults with SCD access to high quality care that decreases the need for hospital admission. Further research needs to be done to evaluate the cost effectiveness of this model. Am. J. Hematol. 90:376–380, 2015. © 2015 Wiley Periodicals, Inc.
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