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Mental health disorders influence admission rates for pain in children with sickle cell disease. Pediatr Blood Cancer 2013 Jul;60(7):1211-4 PMID: 23151972

Pubmed ID

23151972

DOI

10.1002/pbc.24394

Abstract

BACKGROUND: Patients with sickle cell disease (SCD) experience a broad range of mental health disorders placing them at risk for more complicated hospitalizations for pain. The current study examined the impact of mental health disorders on admission rates and hospital length of stay (LOS) for vaso-occlusive pain events (VOE) in pediatric patients with SCD.

PROCEDURE: Patients (5-18 years old) with a primary discharge diagnosis of SCD with crisis were acquired through the Pediatric Health Information System and categorized by history of mental health disorders (mood disorder, anxiety disorder, disruptive behavior disorder, and substance use disorder). Using a retrospective cohort design, hospital admission rates for VOE were examined as the primary outcome and LOS as a secondary outcome.

RESULTS: A total of 5,825 patients accounted for 23,561 admissions for SCD with crisis with approximately 8% of the patients having a mental health diagnosis. Longer LOS was found among patients with a history of any mental health diagnosis (P < 0.0001) and within the mood disorder (P < 0.0001), anxiety disorder (P < 0.0001), and substance use disorder (P = 0.01) subtypes. Hospital admissions rates for VOE were higher among patients with a history of any mental health diagnosis (P < 0.0001) and within the mood disorder (P < 0.0001), anxiety disorder (P < 0.0001), disruptive behavior disorder (P = 0.002), and substance use disorder (P < 0.0001) subtypes.

CONCLUSIONS: Pediatric patients with SCD and a history of a mental health diagnosis have longer LOS and higher admission rates for management of VOE. Ultimately, these findings suggest that mental health pose a challenge to the management of sickle cell pain.

Author List

Myrvik MP, Burks LM, Hoffman RG, Dasgupta M, Panepinto JA

Authors

Matthew Myrvik PhD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Julie A. Panepinto MD, MSPH Professor in the Pediatrics department at Medical College of Wisconsin




Scopus

2-s2.0-84878226155   18 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Anemia, Sickle Cell
Child
Cohort Studies
Female
Hospitalization
Humans
Length of Stay
Male
Pain
Retrospective Studies
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e