title: Trends in Sickle Cell Disease-related Priapism in U.S. Children's Hospitals.
abstract: OBJECTIVE
  To define rates of priapism diagnosis and inpatient admission among males with sickle cell disease (SCD).
  
  
  METHODS
  We retrospectively reviewed the Pediatric Health Information System database for males aged <21 years treated 2004-2012. We identified patients with SCD and priapism based on the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Logistic regression and generalized estimating equation models were used to control for confounding and to adjust for within-hospital clustering of similar patients.
  
  
  RESULTS
  We identified 17,186 males who were admitted 137,710 times during the study period. Of these, 362 (2.1%) were diagnosed with priapism on 748 admissions. There was a significant decrease in the number of priapism admissions among patients with SCD over time (0.81% in 2004 to 0.44% in 2012, P  <  .001). The number of patients diagnosed with SCD-related priapism varied over time without a statistically significant trend (2.3% in 2004, 2.69% in 2008, 1.01% in 2012, P  =  .34). Rates of priapism admissions (0-4.4%) varied widely between hospitals. Older patient age was associated with an increased likelihood of a priapism admission in the multivariate logistic regression model after adjusting for treatment year, hospital region, and for hospital-level clustering of similar patients.
  
  
  CONCLUSIONS
  From 2004 to 2012, the number of admissions for SCD-related priapism declined whereas the number of individual patients diagnosed with SCD-related priapism did not. Rates of priapism-related admissions in males with SCD vary widely among PHIS hospitals.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Hsin-Hsiao Scott
authors.initials: HH
authors.lastname: Wang
authors.affiliation: Department of Urology, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Herbst
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Rothman
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC; Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Nirmish R
authors.initials: NR
authors.lastname: Shah
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC; Department of Pediatrics, Duke University Medical Center, Durham, NC.
authors.forename: John S
authors.initials: JS
authors.lastname: Wiener
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC; Department of Pediatrics, Duke University Medical Center, Durham, NC. Electronic address: jon.routh@duke.edu.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Routh
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011317:Priapism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D055815:Young Adult