• Am J Emerg Med · Jan 2018

    Comparative Study

    Opioid doses and acute care utilization outcomes for adults with sickle cell disease: Emergency department versus acute care unit.

    • Robert E Molokie, Chariz Montminy, Corissa Dionisio, Muhammad Ahmen Farooqui, Michel Gowhari, Yingwei Yao, Marie L Suarez, Miriam O Ezenwa, Judith M Schlaeger, Zaijie J Wang, and Diana J Wilkie.
    • University of Illinois at Chicago, College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, United States; Jesse Brown Veterans Administration Medical Center, 820 S. Damen Avenue, MP 111, Chicago, IL 60612, United States; University of Illinois at Chicago, College of Pharmacy, Department of Biopharmaceutical Sciences, 833 S. Wood Street, Chicago, IL 60612, United States. Electronic address: remolokie@uic.edu.
    • Am J Emerg Med. 2018 Jan 1; 36 (1): 88-92.

    BackgroundAcute care units (ACUs) with focused sickle cell disease (SCD) care have been shown to effectively address pain and limit hospitalizations compared to emergency departments (ED), the reason for differences in admission rates is understudied. Our aim was compare effects of usual care for adult SCD pain in ACU and ED on opioid doses and discharge pain ratings, hospital admission rates and lengths of stay.MethodsIn a retrospective, comparative cohort, single academic tertiary center study, 148 adults with sickle cell pain received care in the ED, ACU or both. From the medical records we documented opioid doses, unit discharge pain ratings, hospital admission rates, and lengths of stay.FindingsPain on admission to the ED averaged 8.7±1.5 and to the ACU averaged 8.0±1.6. The average pain on discharge from the ED was 6.4±3.0 and for the ACU was 4.5±2.5. 70% of the 144 ED visits resulted in hospital admissions as compared to 37% of the 73 ACU visits. Admissions from the ED or ACU had similar inpatient lengths of stay. Significant differences between ED and ACU in first opioid dose and hourly opioid dose were noted.ConclusionsApplying guidelines for higher dosing of opioids for acute painful episodes in adults with SCD in ACU was associated with improved pain outcomes and decreased hospitalizations, compared to ED. Adoption of this approach for SCD pain in ED may result in improved outcomes, including a decrease in hospital admissions.Published by Elsevier Inc.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…