Cargando…

Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study

Sickle cell disease (SCD) is a life-threatening vascular disease that burdens affected persons physically. SCD related vaso-occlusive crises (VOCs) are one of the primary causes of morbidity and mortality. Our objective was to examine the epidemiology of pain crises and the relationship between pain...

Descripción completa

Detalles Bibliográficos
Autores principales: Shah, Nirmish, Bhor, Menaka, Xie, Lin, Arcona, Steve, Halloway, Rashid, Paulose, Jincy, Yuce, Huseyin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Columbia Data Analytics, LLC 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299444/
https://www.ncbi.nlm.nih.gov/pubmed/32685584
http://dx.doi.org/10.36469/9667
_version_ 1783547388204417024
author Shah, Nirmish
Bhor, Menaka
Xie, Lin
Arcona, Steve
Halloway, Rashid
Paulose, Jincy
Yuce, Huseyin
author_facet Shah, Nirmish
Bhor, Menaka
Xie, Lin
Arcona, Steve
Halloway, Rashid
Paulose, Jincy
Yuce, Huseyin
author_sort Shah, Nirmish
collection PubMed
description Sickle cell disease (SCD) is a life-threatening vascular disease that burdens affected persons physically. SCD related vaso-occlusive crises (VOCs) are one of the primary causes of morbidity and mortality. Our objective was to examine the epidemiology of pain crises and the relationship between pain crises and major acute complications among SCD patients. Using the Medicaid Analytic Extracts from 2009-2013, patients with SCD were selected and the first clinical claim indicating SCD during the identification period was defined as the index date. Patients were required to have continuous Medicaid enrollment for ≥6 months pre- and 12 months post-index period. Clinical outcomes included mortality, inpatient pain crises, and complications. Cox regressions were applied to examine the relationship between pain crises and deaths or acute complications, respectively. A total of 20 909 patients were included with a mean age of 17.9 years. The rate of VOC events in 100 person-years was 142.20 for adults and 53.91 for pediatric patients. Patients with VOCs were associated with a higher risk for death (hazard ratio=1.56; 95% confidence interval: [1.19-2.05]) or acute complications including acute chest syndrome, stroke, pulmonary embolism, splenic sequestration, and pulmonary hypertension. SCD patients have a substantial burden of disease-related complications. This study suggests that inpatient vaso-occlusive crisis is a key risk factor for acute complications.
format Online
Article
Text
id pubmed-7299444
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Columbia Data Analytics, LLC
record_format MEDLINE/PubMed
spelling pubmed-72994442020-07-16 Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study Shah, Nirmish Bhor, Menaka Xie, Lin Arcona, Steve Halloway, Rashid Paulose, Jincy Yuce, Huseyin J Health Econ Outcomes Res Hematology Sickle cell disease (SCD) is a life-threatening vascular disease that burdens affected persons physically. SCD related vaso-occlusive crises (VOCs) are one of the primary causes of morbidity and mortality. Our objective was to examine the epidemiology of pain crises and the relationship between pain crises and major acute complications among SCD patients. Using the Medicaid Analytic Extracts from 2009-2013, patients with SCD were selected and the first clinical claim indicating SCD during the identification period was defined as the index date. Patients were required to have continuous Medicaid enrollment for ≥6 months pre- and 12 months post-index period. Clinical outcomes included mortality, inpatient pain crises, and complications. Cox regressions were applied to examine the relationship between pain crises and deaths or acute complications, respectively. A total of 20 909 patients were included with a mean age of 17.9 years. The rate of VOC events in 100 person-years was 142.20 for adults and 53.91 for pediatric patients. Patients with VOCs were associated with a higher risk for death (hazard ratio=1.56; 95% confidence interval: [1.19-2.05]) or acute complications including acute chest syndrome, stroke, pulmonary embolism, splenic sequestration, and pulmonary hypertension. SCD patients have a substantial burden of disease-related complications. This study suggests that inpatient vaso-occlusive crisis is a key risk factor for acute complications. Columbia Data Analytics, LLC 2019-05-03 /pmc/articles/PMC7299444/ /pubmed/32685584 http://dx.doi.org/10.36469/9667 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Hematology
Shah, Nirmish
Bhor, Menaka
Xie, Lin
Arcona, Steve
Halloway, Rashid
Paulose, Jincy
Yuce, Huseyin
Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title_full Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title_fullStr Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title_full_unstemmed Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title_short Evaluation of Vaso-occlusive Crises in United States Sickle Cell Disease Patients: A Retrospective Claims-based Study
title_sort evaluation of vaso-occlusive crises in united states sickle cell disease patients: a retrospective claims-based study
topic Hematology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299444/
https://www.ncbi.nlm.nih.gov/pubmed/32685584
http://dx.doi.org/10.36469/9667
work_keys_str_mv AT shahnirmish evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT bhormenaka evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT xielin evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT arconasteve evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT hallowayrashid evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT paulosejincy evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy
AT yucehuseyin evaluationofvasoocclusivecrisesinunitedstatessicklecelldiseasepatientsaretrospectiveclaimsbasedstudy