Sickle cell disease complications: Prevalence and resource utilization.
<h4>Objectives</h4>This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.<h4>Metho...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0214355 |
| _version_ | 1818401292061507584 |
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| author | Nirmish Shah Menaka Bhor Lin Xie Jincy Paulose Huseyin Yuce |
| author_facet | Nirmish Shah Menaka Bhor Lin Xie Jincy Paulose Huseyin Yuce |
| author_sort | Nirmish Shah |
| collection | DOAJ |
| description | <h4>Objectives</h4>This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.<h4>Methods</h4>The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for ≥6 months baseline and ≥12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC with concomitant SCD complications) episodes, and reasons for ER visits and inpatient stays were analyzed descriptively.<h4>Results</h4>A total of 8,521 patients were included in the analysis, with a median age of 30 years. The average follow-up period was 2.7 years. The rate of VOC episodes anytime in the follow-up was 3.31 in person-years. During the first-year follow-up period, an average of 2.79 VOC episodes were identified per SCD patients, with 1.06 VOC episodes treated in inpatient setting and 0.90 VOC episodes in ER without admission. A total of 76,154 VOC episodes were identified during the entire follow-up period for the overall SCD patients. Most of the VOC episodes (70.3% [n = 53,523]) were uncomplicated episodes, and 29.7% were complicated episodes. Using primary diagnosis claims only, the most frequent complications during the VOC episode were infectious diseases (25.9%), fever (21.8%), and pulmonary disorders (16.2%). Among ER and hospitalizations related to VOC or SCD complication, ~85.0% had VOCs as the primary reason for admission; 15.0% had SCD complications as the primary reason.<h4>Conclusion</h4>In summary, SCD and its related comorbidities and complications result in high acute health care utilization. In addition, VOC remains the primary reason for SCD patients' ER visits and inpatient admissions. |
| first_indexed | 2024-12-14T07:50:09Z |
| format | Article |
| id | doaj.art-53c5f780f1b342eaa82ca3c60c52b0d3 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T07:50:09Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-53c5f780f1b342eaa82ca3c60c52b0d32022-12-21T23:10:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01147e021435510.1371/journal.pone.0214355Sickle cell disease complications: Prevalence and resource utilization.Nirmish ShahMenaka BhorLin XieJincy PauloseHuseyin Yuce<h4>Objectives</h4>This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.<h4>Methods</h4>The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for ≥6 months baseline and ≥12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC with concomitant SCD complications) episodes, and reasons for ER visits and inpatient stays were analyzed descriptively.<h4>Results</h4>A total of 8,521 patients were included in the analysis, with a median age of 30 years. The average follow-up period was 2.7 years. The rate of VOC episodes anytime in the follow-up was 3.31 in person-years. During the first-year follow-up period, an average of 2.79 VOC episodes were identified per SCD patients, with 1.06 VOC episodes treated in inpatient setting and 0.90 VOC episodes in ER without admission. A total of 76,154 VOC episodes were identified during the entire follow-up period for the overall SCD patients. Most of the VOC episodes (70.3% [n = 53,523]) were uncomplicated episodes, and 29.7% were complicated episodes. Using primary diagnosis claims only, the most frequent complications during the VOC episode were infectious diseases (25.9%), fever (21.8%), and pulmonary disorders (16.2%). Among ER and hospitalizations related to VOC or SCD complication, ~85.0% had VOCs as the primary reason for admission; 15.0% had SCD complications as the primary reason.<h4>Conclusion</h4>In summary, SCD and its related comorbidities and complications result in high acute health care utilization. In addition, VOC remains the primary reason for SCD patients' ER visits and inpatient admissions.https://doi.org/10.1371/journal.pone.0214355 |
| spellingShingle | Nirmish Shah Menaka Bhor Lin Xie Jincy Paulose Huseyin Yuce Sickle cell disease complications: Prevalence and resource utilization. PLoS ONE |
| title | Sickle cell disease complications: Prevalence and resource utilization. |
| title_full | Sickle cell disease complications: Prevalence and resource utilization. |
| title_fullStr | Sickle cell disease complications: Prevalence and resource utilization. |
| title_full_unstemmed | Sickle cell disease complications: Prevalence and resource utilization. |
| title_short | Sickle cell disease complications: Prevalence and resource utilization. |
| title_sort | sickle cell disease complications prevalence and resource utilization |
| url | https://doi.org/10.1371/journal.pone.0214355 |
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