title: Saudi SCD patients' symptoms and quality of life relative to the number of ED visits.
abstract: Individuals living with sickle cell disease (SCD) have significantly increased emergency department (ED) use compared to the general population. In Saudi Arabia, health care is free for all individuals and therefore has no bearing on increased ED visits. However, little is known about the relationship between quality of life (QoL) and frequency of acute care utilization in this patient population.
  
  
  
  A cross-sectional study was conducted on 366 patients with SCD who attended the outpatient department at King Fahad Hospital, Hofuf, Saudi Arabia. Data were collected through self-administered surveys, which included: demographics, SCD-related ED visits, clinical issues, and QoL levels. We assessed the ED use by asking for the number of SCD-related ED visits within a 6-month period.
  
  
  
  The self-report survey of ED visits was completed by 308 SCD patients. The median number of SCD-related ED visits within a 6-month time period (IQR) was four (2-7 visits). According to the unadjusted negative binomial model, the rate of SCD-related ED visits increased by (46, 39.3, 40, and 53.5 %) for patients with fever, skin redness with itching, swelling, and blood transfusion, respectively. Poor QoL tends to increase the rate of SCD-related ED visits. Well education and poor general health positively influenced the rate of SCD-related ED visits. Well education tends to increase the rate of SCD-related ED visits by 50.2 %. The rate of SCD-related ED visits decreased by 1.4 % for every point increase in general health.
  
  
  
  Saudi patients with sickle cell disease reported a wide range of SCD-related ED visits. It was estimated that six of 10 SCD patients had at least three ED visits within a 6-month period. Well education and poor general health resulted in an increase in the rate of SCD-related ED visits.
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, College of Public Health and Health Informatics, MC 2350, P.O.Box 22490, Riyadh, 11426, KSA, Saudi Arabia. ahmeda5@vcu.edu.|King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ahmeda5@vcu.edu.
authors.forename: Anwar E
authors.initials: AE
authors.lastname: Ahmed
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, College of Public Health and Health Informatics, MC 2350, P.O.Box 22490, Riyadh, 11426, KSA, Saudi Arabia.|King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.|King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Alaskar
authors.affiliation: Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Donna K
authors.initials: DK
authors.lastname: McClish
authors.affiliation: King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Yosra Z
authors.initials: YZ
authors.lastname: Ali
authors.affiliation: National Anti-Corruption Commission, Riyadh, Saudi Arabia.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Aldughither
authors.affiliation: King Fahad Hospital, Hofuf, Saudi Arabia.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Al-Suliman
authors.affiliation: King Fahad Central Hospital, Jazan, Saudi Arabia.
authors.forename: Hafiz M
authors.initials: HM
authors.lastname: Malhan
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000503:physiopathology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D012529:Saudi Arabia; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Emergency department visits; Inherited anemia; Pain; Quality of life; Sickle cell disease