title: Postdischarge pain, functional limitations and impact on caregivers of children with sickle cell disease treated for painful events.
abstract: This study aimed to describe the outcomes of children with sickle cell disease (SCD) after discharge from medical care for vaso-occlusive painful events and to test the hypothesis that older age, longer length of hospital stay, and a history of frequent vaso-occlusive painful events will be associated with poor outcomes. Children aged 2-18 years with SCD treated in the emergency department or inpatient unit for a painful event were contacted after discharge to assess: days of pain, days of functional limitations for the child, and days of work/school absenteeism for the caregiver. Descriptive statistics were applied and multivariate logistic regression examined the association between the predictors and outcomes. Fifty-eight children were enrolled (mean age 10.8 +/- 4.8 years, 53.5% female). Postdischarge, 46.5% of children reported three or more days of pain, 54.3% had two or more days of functional limitations, and 24.3% of caregivers missed two or more days of work/school. Children with three or more prior painful events had increased odds of a poor outcome postdischarge (OR 1.79; 95% CI = 1.026, 3.096). In conclusion, acute vaso-occlusive painful events impact the lives of children with SCD and their caregivers, even after discharge to home.
authors.affiliation: Pediatric Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of The Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA. abrandow@mcw.edu
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Brandow
authors.forename: David C
authors.initials: DC
authors.lastname: Brousseau
authors.forename: Julie A
authors.initials: JA
authors.lastname: Panepinto
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000293:Adolescent; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D000986:Antisickling Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology*; D002648:Child; D017281:Cost of Illness; D005260:Female; D005838:Genotype; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D010351:Patient Discharge; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000986:Antisickling Agents