Comparison of patients with high pain scores with low-moderate pain scores in pediatric patients with sickle cell disease
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Objective: To better understand the characteristics of patients with persistently high pain scores (mean ≥ 7) as compared to those with persistently low to moderate pain scores (mean ≤ 6). Design: This study was a retrospective chart review that compares high pain patients with sickle cell disease (SCD) and low-moderate pain patients with SCD that were admitted between 2010- 2011. Each chart was reviewed for information relating to demographics, location of pain, clinical course, school progress and family structure. Any numerical measures were compared using t- tests to assess whether differences in mean values were of significance. Results: High pain admissions showed no significant differences in BMI or hemoglobin levels at admission from low-moderate pain admissions. (p= 0.163 and p=0.424, respectively). Mean length of stay (p=0.048) and total length of stay within the two-year period (p=0.002) was significantly greater in high pain admissions. Patients in both groups had similar clinical courses, co-morbidities, long-term medications, hydroxyurea compliance, family structure and school progress. Discussion: Although some factors of high pain patients differed from low pain patients, these differences do not warrant any changes in the form of care for one particular group. Conclusion: Development of a method of intervention that can be administered early in order to decrease the number of pain crises would prove to be a beneficial use of resources. The use of a pain tool specific to SCD could help to standardize pain scores within this population.
Thesis (M.A.)--Boston University