Assessment and prediction of pruritus in sickle cell disease patients: a preliminary study.
OBJECTIVE
The purpose of this study was to better predict and assess pruritus in inpatients and outpatients with sickle cell disease. The aims were to describe the incidence and severity of pruritus using the visual analog scale (VAS) and the National Cancer Institute Common Toxicity Criteria (CTC) scale and to predict pruritus from common complications.


METHODS
This study was a prospective, cross-sectional design.


METHODS
The study was conducted at a Midwestern National Cancer Institute hospital.


METHODS
This prospective, cross-sectional design included patients with a diagnosis of sickle cell disease who were older than 18 years.


METHODS
A demographic data form was used to collect biographical characteristics, and the CTC scale and VAS were used to evaluate pruritus.


RESULTS
The participants (n = 56) were mostly women (62%) and outpatients (58%) and the mean number of complications was 1.9. The mean VAS score was 3.75, and the CTC score was 1.55. For inpatients, the mean VAS score was 5.17, and the CTC score was 1.65. For outpatients, the mean VAS score was 2.76, and CTC score was 1.56. The sensitivity and specificity for the VAS were 75% and 93%, respectively. The CTC scale was 56.2% and 100%, respectively. The difference in the area under the curve between the VAS and the CTC scale was 11.4% in favor of the VAS. Among complications (pulmonary hypertension, liver insufficiency, acute chest syndrome, renal insufficiency, iron overload, and chronic pain medication), chronic pain medication was the only significant predictor.


CONCLUSIONS
Pruritus is common particularly in inpatients as well as outpatients. The VAS is a more sensitive and specific tool to measure pruritus. Chronic pain medication use is a predictor of pruritus.


CONCLUSIONS
Clinicians must make patients aware that pruritus exists especially when pain medication is administered or prescribed.
The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital, and Richard J. Solove Research Institute, Columbus, Ohio, USA.
Deborah
D
Hanes
Judy
J
Jefferson-Gordon
Amy
A
Lindsey
Stefani
S
O'Connor
Lorie
L
Petty
Mary
M
Weiss
Massa
M
Nnadi
Janine
J
Overcash
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015146:Midwestern United States; D011537:Pruritus / Q000503:physiopathology*; D055815:Young Adult