{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:09:08Z","timestamp":1781291348227,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2011,5,16]],"date-time":"2011-05-16T00:00:00Z","timestamp":1305504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vaso\u2010occlusive crises (VOCs) contribute to frequent hospitalizations among children with sickle cell disease (SCD). The objective of this study was to identify factors associated with high resource utilization during hospitalizations for VOC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We analyzed pediatric discharges 0\u201318 years of age with a primary diagnosis of SCD with crisis from the 2006 Kids' Inpatient Database, a nationally representative sample of pediatric hospital discharges. High resource hospitalizations were defined as those in the highest decile for total charges. We conducted sample\u2010weighted regression analyses to determine associations between independent variables (patient demographics, hospital characteristics, illness severity) and high resource use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 9,893 (0.371%) discharges for children with VOCs. Median total hospitalization charges were $10,691. In multivariate analysis, children 15\u201318 years of age (odds ratio [OR] 3.39, 95% confidence interval [CI] 2.54\u20134.53), 10\u201314 years of age (OR 2.72, 95% CI 2.07\u20133.59), and 5\u20139 years of age (OR 1.74, 95% CI 1.30\u20132.34) had higher odds of high resource hospitalizations compared to children 0\u20134 years of age. Care in a children's hospital had three times the odds of high resource use compared to care in a general hospital. Discharges with secondary diagnoses including pneumonia (OR 2.46, 95% CI 1.96\u20133.09) and constipation (OR 1.78, 95% CI 1.31\u20132.40) were also associated with high resource use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Older age and secondary diagnoses were associated with high resource use during VOC hospitalizations. These findings suggest the need to improve adherence to comprehensive care among older children to prevent VOCs and standardize protocols to manage VOC complications. Pediatr Blood Cancer 2012; 58: 584\u2013590. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.23181","type":"journal-article","created":{"date-parts":[[2011,5,16]],"date-time":"2011-05-16T15:45:19Z","timestamp":1305560719000},"page":"584-590","source":"Crossref","is-referenced-by-count":47,"title":["High resource hospitalizations among children with vaso\u2010occlusive crises in sickle cell disease"],"prefix":"10.1002","volume":"58","author":[{"given":"Jean L.","family":"Raphael","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghua","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitta U.","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,5,16]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10305"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20703"},{"key":"e_1_2_6_4_2","first-page":"40","article-title":"Cost of hospitalizations associated with sickle cell disease in the United States","volume":"112","author":"Davis H","year":"1997","journal-title":"Public Health Rep"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(200005)64:1<26::AID-AJH5>3.0.CO;2-F"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21408"},{"key":"e_1_2_6_7_2","unstructured":"SteinerCA MillerJL. 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