Differences in pain management between hematologists and hospitalists caring for patients with sickle cell disease hospitalized for vasoocclusive crisis.

Published

Journal Article

Sickle cell disease (SCD) is a chronic disease characterized by multiple vaso-occlusive complications and is increasingly cared for by hospitalists. The purpose of this study is to examine differences in pain management between hematologists and hospitalists.We performed a single-institution, retrospective review of pain management patterns and outcomes in adult SCD patients hospitalized for vaso-occlusive crisis.Over 26 months, we found a total of 298 patients (120 cared for by the hematologists and 178 by hospitalists), with a mean age of 32 (range 19-58). Patients cared for by hospitalists had a lower total number of hours on a patient controlled analgesia (PCA) device (171 vs. 212 hours, P=0.11). Hospitalists also were significantly more likely to utilize demand only PCA (42% vs. 23%, P=0.002) and had a significantly lower rate of using both continuous and demand PCA (54% vs. 67%, P=0.04). In addition, patients cared for by hospitalists had a significantly shorter hospitalization (8.4 days) compared to hematologists (10 days, P=0.04) with a non-significant difference in 7 and 30 day readmission rates (7.2% vs. 6.7% and 40% vs. 35% respectively).We found patients cared for by hospitalists more frequently utilized home oral pain medication during admission, had shorter lengths of hospitalization, and did not have a significant increase in readmission rates.

Full Text

Duke Authors

Cited Authors

  • Shah, N; Rollins, M; Landi, D; Shah, R; Bae, J; De Castro, LM

Published Date

  • March 2014

Published In

Volume / Issue

  • 30 / 3

Start / End Page

  • 266 - 268

PubMed ID

  • 23669451

Pubmed Central ID

  • 23669451

Electronic International Standard Serial Number (EISSN)

  • 1536-5409

International Standard Serial Number (ISSN)

  • 0749-8047

Digital Object Identifier (DOI)

  • 10.1097/AJP.0b013e318295ec04

Language

  • eng