Hospital readmission for adult acute sickle cell painful episodes: frequency, etiology, and prognostic significance.

Abstract:

:The acute sickle cell painful episode is the most common cause of hospitalization of patients with sickle cell anemia. Its detailed clinical features and peri-discharge features are not well known. In order to determine the actual pattern of hospital admissions of patients with SS and the causes of frequent hospital readmissions and their prognostic significance, we conducted a prospective longitudinal and observation cohort study of all adult patients with sickle cell anemia admitted to Thomas Jefferson University Hospital between January 1998 and December 2002. Major outcome measures included the frequency, etiology, and prognostic significance of readmissions to the hospital within 1 week and 1 month after discharge. Incidence of mortality among patients during the study period was also determined. Analysis of the data showed that about 50% of hospital admissions for acute painful episodes were readmitted within 1 month after discharge, and about 16% of all admissions were within 1 week after discharge. The intensity of pain score decreased significantly during the first 4 days of hospital admission (P < 0.001) and then reached a plateau until discharge. The mean score of pain intensity was >7 throughout the hospital stay. Causes of hospital readmission included premature discharge, withdrawal syndrome, and recurrence of new acute episodes. Readmission within 1 week after discharge was associated with higher mortality than otherwise. This study shows that hospital readmission of adult patients with sickle cell anemia is common. It suggests that improvement is needed in the management of pain during hospitalization and at home after discharge. Patients who are readmitted frequently within 1 week of discharge have poor prognosis and require careful monitoring.

journal_name

Am J Hematol

authors

Ballas SK,Lusardi M

doi

10.1002/ajh.20336

keywords:

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

17-25

issue

1

eissn

0361-8609

issn

1096-8652

journal_volume

79

pub_type

杂志文章
  • Disseminated intravascular coagulation due to cytomegalovirus infection in an immunocompetent adult treated with plasma exchange.

    abstract::We report the case of an immunocompetent woman who developed disseminated intravascular coagulation (DIC) due to acute cytomegalovirus (CMV) infection and was successfully treated with plasma exchange. Extensive investigations revealed no other cause for her DIC, and she did not have any recurrence after more than 1 y...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.20602

    authors: Niewold TB,Bundrick JB

    更新日期:2006-06-01 00:00:00

  • The "Hageman" connection: interrelationships of blood coagulation, fibrino(geno)lysis, kinin generation, and complement activation.

    abstract::The activation pathways for the generation of enzymes involved in blood clotting, clot lysis, complement activation, and kinin generation are briefly reviewed. The interrelationship of the four systems is illustrated by the multiple functions of four key enzymes: Factor XIIa, kallikrein, plasmin, and C1 esterase. The ...

    journal_title:American journal of hematology

    pub_type: 杂志文章,评审

    doi:10.1002/ajh.2830040412

    authors: Murano G

    更新日期:1978-01-01 00:00:00

  • Idiopathic autoimmune thrombocytopenia: evidence for redistribution of platelet antibodies into the circulation after immunoadsorption treatment.

    abstract::Platelet antibodies are detectable in only about 50% of patients with chronic autoimmune thrombocytopenia (AITP). We determined platelet antibodies against GPIa/IIa, GPIb/IX, GPIIb/IIIa, and GPV and reticulated platelets in three female patients with AITP, before and after immunoadsorption treatment. None of the three...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.10312

    authors: Leitner GC,Stiegler G,Horvath M,Hoecker P,Sagaster P,Panzer S

    更新日期:2003-05-01 00:00:00

  • Antitumor effects of celecoxib on K562 leukemia cells are mediated by cell-cycle arrest, caspase-3 activation, and downregulation of Cox-2 expression and are synergistic with hydroxyurea or imatinib.

    abstract::Celecoxib, a specific cyclooxygenase-2 (Cox-2) inhibitor, has been shown to possess antitumor activity in a variety of cancer cells. However, the antitumor activity of celecoxib in hematopoietic tumors, especially in chronic myeloid leukemia (CML), has not been well established. This study was designed to investigate ...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.20542

    authors: Zhang GS,Liu DS,Dai CW,Li RJ

    更新日期:2006-04-01 00:00:00

  • Severe thrombotic tendency associated with a type I plasminogen deficiency.

    abstract::We report a 45-year-old female patient with recurrent spontaneous deep vein thrombosis associated with an isolated hypoplasminogenemia (plasminogen activity and antigen level of 42% and 37%, respectively). The plasminogen molecule was normal as demonstrated by a normal activation by tissue plasminogen activator, elect...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830300107

    authors: Leebeek FW,Knot EA,Ten Cate JW,Traas DW

    更新日期:1989-01-01 00:00:00

  • Elevated plasma endothelin-1 levels in sickle cell anemia: relationships to oxygen saturation and left ventricular hypertrophy.

    abstract::Endothelin-1 (Et-1) is a vasoconstrictor produced by endothelial and vascular smooth muscle cells in response to hypoxia, which induces hypertrophy in cultured cardiac myocytes. We measured plasma Et-1 levels and left ventricular dimensions in 13 patients with sickle cell anemia (SCD) and in 12 African-American contro...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(sici)1096-8652(199807)58:3<195::aid-ajh6>

    authors: Werdehoff SG,Moore RB,Hoff CJ,Fillingim E,Hackman AM

    更新日期:1998-07-01 00:00:00

  • Teardrop-shaped red cells in autoimmune hemolytic anemia.

    abstract::The presence of teardrop-shaped red cells in peripheral blood has traditionally been felt to reflect altered marrow architecture, namely myelofibrosis. We evaluated two patients with splenomegaly, moderately severe hemolytic anemia due to warm-reactive IgG anti-red cell autoantibody, and bone marrow erythroid hyperpla...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830210410

    authors: Farolino DL,Rustagi PK,Currie MS,Doeblin TD,Logue GL

    更新日期:1986-04-01 00:00:00

  • Protein-bound cobalamin absorption declines in the elderly.

    abstract::A modified protein-bound cobalamin absorption test was used to study dietary cobalamin absorption in healthy adults of different age groups and patients with isolated low serum concentrations of cobalamin. Dietary cobalamin absorption was significantly reduced in healthy adults aged 55-75 years compared with young adu...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830390202

    authors: Scarlett JD,Read H,O'Dea K

    更新日期:1992-02-01 00:00:00

  • Cell-mediated immune-pancytopenia complicating primary Sjögren's syndrome.

    abstract::A 64-year-old woman with mild bilateral parotid gland swelling and bilateral lower extremity purpura was admitted for evaluation of xerostomia and pancytopenia. The patient had an increased erythrocyte sedimentation rate, pancytopenia, and positive tests for antibodies to nuclear antigen, SS-A, and SS-B. Impaired cell...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830430312

    authors: Seki T,Kiyosawa K,Monno S,Imai Y,Furukawa K,Kumazawa S,Ota M,Saito H,Furuta S,Nakahata T

    更新日期:1993-07-01 00:00:00

  • Haplotypes and levels of fetal hemoglobin and G gamma to A gamma ratios in Mediterranean patients with thalassemia minor and major.

    abstract::This study concerned the gamma chain composition of Hb F and the haplotypes of 44 patients with beta-thalassemia major or intermedia and many of their relatives. Seventeen patients came from Northern (Turkish) Cyprus, 12 from the Istanbul area, and 15 from Macedonia and Bulgaria. Analysis of the A gamma T-G gamma-A ga...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830200103

    authors: Aksoy M,Kutlar A,Efremov GD,Nikolov N,Petkov G,Reese AL,Harano T,Chen SS,Huisman TH

    更新日期:1985-09-01 00:00:00

  • Trends in anti-D immune globulin for childhood immune thrombocytopenia: usage, response rates, and adverse effects.

    abstract::In 2010, the Food and Drug Administration (FDA) added a black box warning to anti-D immune globulin (Rho(D) immune globulin, anti-D) for immune thrombocytopenia (ITP) to warn of the complications related to severe hemolysis. The objective of this retrospective medical record review was to examine recent trends in anti...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.22261

    authors: Long M,Kalish LA,Neufeld EJ,Grace RF

    更新日期:2012-03-01 00:00:00

  • Idiopathic immune-mediated acquired von Willebrand's disease in a patient with angiodysplasia: demonstration of an unusual inhibitor causing a functional defect and rapid clearance of von Willebrand factor.

    abstract::A case of idiopathic immune-mediated von Willebrand's disease (AvWD) associated angiodysplasia and recurrent lower gastrointestinal bleeding is reported. Coagulation parameters at presentation were activated partial thromboplastin time of 41 sec, bleeding time >15 min, factor VIII procoagulant activity, 5%; von Willeb...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(sici)1096-8652(199902)60:2<151::aid-ajh13

    authors: Alhumood SA,Devine DV,Lawson L,Nantel SH,Carter CJ

    更新日期:1999-02-01 00:00:00

  • Stomatocytic transformation of red blood cells after marathon running.

    abstract::We studied red blood cell morphology in two marathon runners before, immediately after, and 1 day after a marathon race. A discocyte-stomatocyte transformation was found by light microscopy of wet preparations and also by scanning electron microscopy, with about one-half the erythrocytes becoming cup-shaped after the ...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830190213

    authors: Reinhart WH,Chien S

    更新日期:1985-06-01 00:00:00

  • Prenatal and molecular diagnosis of hemophilia B.

    abstract::Prenatal diagnosis was carried out on a woman who had previously given birth to a son with a spontaneous mutation of C-->T transition at nt 31133 of the factor IX (F.IX) gene. The diagnosis was performed on chorionic villi sampling by the method of amplification-created restriction site (ACRS). It revealed a female fe...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(SICI)1096-8652(199608)52:4<243::AID-AJH1>

    authors: Young JH,Wang JC,Gau JP,Hu HT

    更新日期:1996-08-01 00:00:00

  • Functional analysis of the marginating pool of human polymorphonuclear leukocytes.

    abstract::The intravascular pool of human polymorphonuclear leukocytes (PMN) is composed of one compartment which is circulating and another that is marginated to the vascular endothelium. Administration of B-adrenergic agonists leads to a rapid demargination with an increase in the circulating PMN pool. The marginating PMN has...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830240107

    authors: Berkow RL,Dodson RW

    更新日期:1987-01-01 00:00:00

  • Acquired hypoprothrombinemia: effects of danazol treatment.

    abstract::The lupus anticoagulant may be accompanied by an acquired factor II deficiency and bleeding. We report on a patient with a lupus anticoagulant and factor II (Fll) deficiency responsive to Danazol. Acquired hypoprothrombinemia (FII) with the lupus anticoagulant (LA) may be accompanied by a hemorrhagic diathesis. A 64-y...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(SICI)1096-8652(199612)53:4<272::AID-AJH14

    authors: Williams S,Linardic C,Wilson O,Comp P,Gralnick HR

    更新日期:1996-12-01 00:00:00

  • Reduced intensity conditioning regimen with fludarabine, busulfan, and low-dose TBI (Flu-BU2-TBI): clinical efficacy in high-risk patients.

    abstract::Reduced intensity conditioning (RIC) regimens are widely used in allogeneic stem cell transplantation (SCT). In this study, we retrospectively investigated the clinical outcomes of RIC with fludarabine (Flu; 180 mg/m(2)), intravenous busulfan (BU; 6.4 mg/kg) or oral BU (8 mg/kg), and low-dose total body irradiation (T...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.21630

    authors: Takahata M,Hashino S,Okada K,Onozawa M,Kahata K,Sugita J,Shigematsu A,Kondo T,Yamamoto S,Endo T,Nishio M,Ito YM,Tanaka J,Koike T,Asaka M,Imamura M

    更新日期:2010-04-01 00:00:00

  • The prognostic value of monosomal karyotype (MK) in higher-risk patients with myelodysplastic syndromes treated with 5-Azacitidine: A retrospective analysis of the Hellenic (Greek) Myelodysplastic syndromes Study Group.

    abstract::In this study, we investigated the incidence and prognostic impact of monosomal karyotype (MK) in 405 higher-risk Myelodysplastic Syndromes (MDS) patients treated with 5-AZA. The MK was present in 66 out of 405 (16.3%) patients, most of whom had complex karyotype (CK). MK was strongly associated with CK and the cytoge...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.25111

    authors: Papageorgiou SG,Vasilatou D,Kontos CK,Kotsianidis I,Symeonidis A,Galanopoulos AG,Hatzimichael E,Megalakaki A,Poulakidas E,Diamantopoulos P,Vassilakopoulos TP,Zikos P,Papadaki H,Mparmparousi D,Bouronikou E,Panayiotidis P,V

    更新日期:2018-07-01 00:00:00

  • Hemosiderosis with diabetes mellitus in untransfused Hemoglobin H disease.

    abstract::A 37-year-old untransfused, non-drinking man with Hemoglobin H-CS disease presented with insulin-dependent diabetes mellitus, markedly elevated serum ferritin level, and marked iron deposition in hepatocytes. He did not carry either of the two common mutations of the HLA-H gene for hereditary hemochromatosis, namely, ...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(sici)1096-8652(199802)57:2<160::aid-ajh12

    authors: Chim CS,Chan V,Todd D

    更新日期:1998-02-01 00:00:00

  • Continuous flow method for determination of erythrocyte osmotic fragility.

    abstract::A simple and accurate micromethod for the determination of erythrocyte osmotic fragility is introduced. The method uses a laminar parabolic flow pattern, together with gravity, to retain cells in a long, small-diameter tube while a solution with decreasing osmolarity is passed through the tube. As the cells hemolyze, ...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830020411

    authors: Ito Y,Carmeci P,Steele R

    更新日期:1977-01-01 00:00:00

  • CD71 phenotype and the value of gallium imaging in lymphomas.

    abstract::Tumor cells of 14 cases of non-Hodgkin lymphomas and 2 cases of Hodgkin disease were tested for the presence of the transferrin receptor (CD71) by flow cytofluorimetry before 67gallium imaging. It appeared that expression of CD71 phenotype was closely related to the positivity of gallium scan before therapy. We feel t...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830360313

    authors: Feremans W,Bujan W,Neve P,Delville JP,Schandene L

    更新日期:1991-03-01 00:00:00

  • Epstein-Barr virus infection in Richter's transformation.

    abstract::Chronic lymphocytic leukemia (CLL) may convert to a diffuse large cell lymphoma (Richter's syndrome) over time. In occasional cases of Richter's transformation, Epstein-Barr virus (EBV) has been identified in the lymphoma cells. To evaluate the association of EBV infection with Richter's syndrome, the biopsy specimens...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(sici)1096-8652(199902)60:2<99::aid-ajh3>3

    authors: Ansell SM,Li CY,Lloyd RV,Phyliky RL

    更新日期:1999-02-01 00:00:00

  • Rituximab in combination with chemotherapy versus chemotherapy alone in HIV-associated non-Hodgkin lymphoma: a pooled analysis of 15 prospective studies.

    abstract::In HIV-positive patients with non-Hodgkin lymphoma (NHL), no benefit of adding rituximab to chemotherapy was seen in a randomized controlled trial (RCT). We performed a meta-analysis of prospective studies to ascertain outcomes in HIV-positive NHL patients treated with chemotherapy (chemo) versus rituximab and chemo (...

    journal_title:American journal of hematology

    pub_type: 杂志文章,meta分析

    doi:10.1002/ajh.22275

    authors: Castillo JJ,Echenique IA

    更新日期:2012-03-01 00:00:00

  • Comparative study of micro-transplantation from HLA fully mismatched unrelated and partly matched related donors in acute myeloid leukemia.

    abstract::Micro-transplantation (MST) by chemotherapy, combined with granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (GPBSC) infusion, from an HLA partial matched related donor has shown some encouraging effective therapy for acute myeloid leukemia (AML). However, the outcome of human leukocyte antige...

    journal_title:American journal of hematology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/ajh.25780

    authors: Hu KX,Du X,Guo M,Yu CL,Qiao JH,Sun QY,Zuo HL,Cai B,Huang YJ,Ai HS,Dong Z,Wang Y

    更新日期:2020-06-01 00:00:00

  • Laparoscopic splenectomies for idiopathic thrombocytopenic purpura: experience of sixty cases.

    abstract::We performed a laparoscopic splenectomy (LS) in 60 patients (age 9-83, 45 females) with idiopathic thrombocytopenic purpura (ITP) who did not achieve sustained remission on steroid therapy. Using a modified procedure, the mean duration of LS was 78 min (range 25-240 min) and surgery was associated with only 5% major a...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/(sici)1096-8652(200001)63:1<7::aid-ajh2>3.

    authors: Szold A,Schwartz J,Abu-Abeid S,Bulvik S,Eldor A

    更新日期:2000-01-01 00:00:00

  • Mutant calreticulin-expressing cells induce monocyte hyperreactivity through a paracrine mechanism.

    abstract::Mutations in the calreticulin gene (CALR) were recently identified in approximately 70-80% of patients with JAK2-V617F-negative essential thrombocytosis and primary myelofibrosis. All frameshift mutations generate a recurring novel C-terminus. Here we provide evidence that mutant calreticulin does not accumulate effic...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.24245

    authors: Garbati MR,Welgan CA,Landefeld SH,Newell LF,Agarwal A,Dunlap JB,Chourasia TK,Lee H,Elferich J,Traer E,Rattray R,Cascio MJ,Press RD,Bagby GC,Tyner JW,Druker BJ,Dao KH

    更新日期:2016-02-01 00:00:00

  • Which steroids should we choose for the treatment of adult acute lymphoblastic leukemia?

    abstract::Corticosteroids are essential and one of the mainstays in the treatment of acute lymphoblastic leukemia (ALL). In vitro assays show that dexamethasone(DXM) is five to six times more cytotoxic to leukemic lymphoblasts than prednisolone (PDN) [1], and the use of DXM as an alternative drug for PDN is an important issue i...

    journal_title:American journal of hematology

    pub_type: 信件,随机对照试验

    doi:10.1002/ajh.21827

    authors: Zheng C,Liu X,Wu J,Cai X,Zhu W,Sun Z

    更新日期:2010-10-01 00:00:00

  • Symptoms of depression and anxiety in patients with thalassemia: prevalence and correlates in the thalassemia longitudinal cohort.

    abstract::Thalassemia is an inherited blood disorder that requires lifelong adherence to a complicated and burdensome medical regimen which could potentially impact emotional functioning of patients. The importance of understanding and promoting healthy emotional functioning is crucial not only to psychological well-being, but ...

    journal_title:American journal of hematology

    pub_type: 信件,多中心研究

    doi:10.1002/ajh.21826

    authors: Mednick L,Yu S,Trachtenberg F,Xu Y,Kleinert DA,Giardina PJ,Kwiatkowski JL,Foote D,Thayalasuthan V,Porter JB,Thompson AA,Schilling L,Quinn CT,Neufeld EJ,Yamashita R,Thalassemia Clinical Research Network.

    更新日期:2010-10-01 00:00:00

  • Late appearance of the Philadelphia chromosome with monosomy 7 in a patient with de novo AML with trilineage myelodysplasia.

    abstract::We report here a patient with de novo acute myelocytic leukemia with trilineage myelodysplasia (AML/TMDS) in whom cytogenetic analysis was normal at diagnosis and in whom Philadelphia chromosome (Ph1) with monosomy 7 emerged at the terminal stage of the disease. Reverse transcription polymerse chain reaction (RT-PCTR)...

    journal_title:American journal of hematology

    pub_type: 杂志文章

    doi:10.1002/ajh.2830490413

    authors: Matsue K,Miyamoto T,Ito M,Tsukuda K

    更新日期:1995-08-01 00:00:00

  • Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management.

    abstract:DISEASE OVERVIEW:Polycythemia vera (PV) and essential thrombocythemia (ET) are myeloproliferative neoplasms primarily characterized by erythrocytosis and thrombocytosis, respectively. Other disease features include leukocytosis, splenomegaly, thrombohemorrhagic complications, vasomotor disturbances, pruritus, and a sma...

    journal_title:American journal of hematology

    pub_type: 杂志文章,评审

    doi:10.1002/ajh.21946

    authors: Tefferi A

    更新日期:2011-03-01 00:00:00