title: The proportion of potentially preventable emergency department visits by patients with sickle cell disease.
abstract: BACKGROUND
  Emergency department (ED) visits by children with sickle cell disease (SCD) are often classified as urgent based on resource utilization. This classification may not accurately reflect the potentially preventable nature of SCD visits. We sought to determine the proportion of SCD crisis-related pediatric ED visits that are possibly preventable.
  
  
  METHODS
  We reviewed 2 years of ED visits with a diagnosis of SCD with crisis at a hospital with an established sickle cell program. Criteria for preventable visits were predefined by pediatric hematologists. Non-pain-related chief complaints requiring emergent evaluation or painful episodes preceded by 2 opioid doses were considered not preventable; others were potentially preventable.
  
  
  RESULTS
  The study included 603 visits by 187 patients; 33% were potentially preventable. Overall, 29% of visits were emergent based on non-pain-related emergent complaints. Of the remaining pain-related visits, 26% were preceded by 2 or more doses of opioids at home. Visits by children with asthma were 0.58 times as likely to be preventable, due to more non-pain-related emergent chief complaints (32%) and more children (36%) taking 2 or more opioid doses.
  
  
  CONCLUSIONS
  Approximately two thirds of SCD crisis-related pediatric ED visits are not immediately preventable; that percentage is higher in children with asthma.
authors: Departments of *Pediatric Emergency Medicine †Quantitative Health Sciences ‡Pediatric Hematology, Medical College of Wisconsin, Milwaukee, WI.
authors: Mark
authors: M
authors: Nimmer
authors: Raymond G
authors: RG
authors: Hoffmann
authors: Mahua
authors: M
authors: Dasgupta
authors: Julie
authors: J
authors: Panepinto
authors: David C
authors: DC
authors: Brousseau
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000755:Anemia, Sickle Cell / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid