Outcomes before and after providing interdisciplinary hematology and pulmonary care for children with sickle cell disease.
Outcomes before and after providing interdisciplinary hematology and pulmonary care for children with sickle cell disease.
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DOI：
10.1182/bloodadvances.2022009079
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发表时间：
2023-05-23
期刊：
影响因子：
7.5
通讯作者：
Creary, Susan
中科院分区：
文献类型：
--
作者：
Zeno, Rachel N.;Stanek, Joseph;Pugh, Courtney;Gillespie, Michelle;Kopp, Benjamin T.;Creary, Susan
多学科SCD-肺科门诊与SCD儿童肺部结局改善和急性护理使用减少相关。患有镰状细胞病（SCD）的人有患上肺部疾病的风险，这些疾病使他们的SCD复杂化，但往往面临医疗保健的障碍。2014年，在全国儿童医院（NCH）创建了一个跨学科诊所，为COPD提供肺部护理，以解决可能阻碍优化治疗的准入障碍。我们假设，与2年前相比，在首次SCD-肺部门诊访视后2年内，COPD和肺部疾病患者因急性胸部综合征（ACS）、哮喘和血管闭塞发作而住院的次数较少。从2014年到2020年，119名患者在SCD-肺科诊所接受了评估，并在首次访视前后在NCH进行了至少2年的随访。收集急性护理结局、肺功能、多导睡眠图、超声心动图、实验室和药物处方数据，并使用Wilcoxon符号排名和McNemar检验进行分析。与2年前相比，在接受ICD肺部临床评估后的2年内，ACS（P <0.001）和哮喘（P = 0.006）的中位急诊就诊次数显著减少。哮喘和过敏性鼻炎的诊断率更高，在SCD后肺部门诊期间，使用羟基脲（P = 0.005）和吸入性皮质类固醇（P = 0.005）的处方更常见。在SCD-肺科临床评估后2年，全身性皮质类固醇处方的中位数较低（P < .0001）。乳酸脱氢酶和白色血细胞计数也显著降低。实施多学科SCD-肺科门诊是可行的，可以改善肺部问题的管理，并改善健康和急性护理的使用。
A multidisciplinary SCD-pulmonary clinic is associated with improved pulmonary outcomes and reduced acute care use among children with SCD. People with sickle cell disease (pwSCD) are at risk of developing lung conditions that complicate their SCD but often face health care access barriers. An interdisciplinary clinic providing pulmonary care for pwSCD was created in 2014 at the Nationwide Children’s Hospital (NCH) to address access barriers that may prevent optimized treatment. We hypothesize that pwSCD and pulmonary disease would have fewer hospitalizations for acute chest syndrome (ACS), asthma, and vaso-occlusive episodes in the 2 years after their initial SCD-pulmonary clinic visit compared with the 2 years before. From 2014 to 2020, 119 pwSCD were evaluated in the SCD-pulmonary clinic and followed up at the NCH for at least 2 years before and after this initial visit. Acute care outcomes, pulmonary function, polysomnography, echocardiogram, laboratory, and medication prescribing data were collected and analyzed using the Wilcoxon signed ranked and McNemar tests. The median number of acute care visits for ACS (P < .001) and asthma (P = .006) were significantly lower during the 2 years after pwSCD’s initial SCD-pulmonary clinic evaluation compared with the 2 years before. Asthma and allergic rhinitis were more frequently diagnosed and prescriptions for hydroxyurea (P = .005) and inhaled corticosteroids (P = .005) were more common in the post–SCD-pulmonary clinic period. The median number of prescribed systemic corticosteroids was lower in the 2 years after SCD-pulmonary clinic evaluation (P < .0001). Lactate dehydrogenase and white blood cell counts also significantly decreased. Implementing a multidisciplinary SCD-pulmonary clinic is feasible and may allow improved management of pulmonary problems and lead to improvements in the usage of health and acute care.
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DOI：
10.3390/ph3030514
发表时间：
2010-03-08
期刊：
Pharmaceuticals (Basel, Switzerland)
影响因子：
--
作者：
Barnes PJ
通讯作者：
Barnes PJ
影响因子：
13.8
作者：
Lubeck, Deborah;Agodoa, Irene;Lanzkron, Sophie
通讯作者：
Lanzkron, Sophie
影响因子：
158.5
作者：
PLATT, OS;BRAMBILLA, DJ;KLUG, PP
通讯作者：
KLUG, PP
影响因子：
2.8
作者：
Houwing ME;Buddenbaum M;Verheul TCJ;de Pagter APJ;Philipsen JNJ;Hazelzet JA;Cnossen MH
通讯作者：
Cnossen MH
影响因子：
1.4
作者：
Powell, Rhea E.;Lovett, Paris B.;Pulte, Dianne
通讯作者：
Pulte, Dianne