{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:12:15Z","timestamp":1767982335240,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,4]],"date-time":"2012-01-04T00:00:00Z","timestamp":1325635200000},"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":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vaso\u2010occlusive crises (VOC) contribute to frequent hospitalizations among children with sickle cell disease (SCD). The objective of this study was to determine whether length of stay (LOS) has decreased for VOC hospitalizations between 1997 and 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We analyzed pediatric discharges (aged 0\u201318) with a primary or secondary diagnosis of SCD with crisis from the Kid's Inpatient Database (years 1997, 2003, and 2009), a nationally representative sample of pediatric hospital discharges. We conducted bivariate and multivariate, sample\u2010weighted linear regression analyses to determine associations between independent variables (patient demographics, hospital characteristics, co\u2010diagnoses, and procedures) and LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both the number (22,661\u201321,741) and proportion of VOC hospitalizations (0.34\u20130.29%) among all pediatric hospitalizations marginally decreased between 1997 and 2009 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Mean LOS decreased from 4.59 to 4.21 days (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). For all study years, older age was the only socio\u2010demographic variable associated with longer LOS, controlling for other factors. Between 1997 and 2009, LOS decreased for all age categories, with the largest statistically significant reduction occurring among adolescents (5.69\u20134.76 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nationally representative hospital data indicate modest but meaningful reductions in LOS for children with VOC over a 12\u2010year period. Adolescents who typically have the greatest disease severity showed the largest reduction in LOS. However, adolescents continue to account for a large proportion of inpatient stays for VOC. These findings illustrate that the adolescent period is a critical time in the lifespan for targeted intervention. Pediatr Blood Cancer 2012;59:679\u2013684. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24065","type":"journal-article","created":{"date-parts":[[2012,1,5]],"date-time":"2012-01-05T09:00:20Z","timestamp":1325754020000},"page":"679-684","source":"Crossref","is-referenced-by-count":8,"title":["Shorter hospitalization trends among children with sickle cell disease"],"prefix":"10.1002","volume":"59","author":[{"given":"Jean L.","family":"Raphael","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitta U.","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc A.","family":"Kowalkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzette O.","family":"Oyeku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,4]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"80","article-title":"Comparison of costs to the health sector of comprehensive and episodic health care for sickle cell disease patients","volume":"110","author":"Yang YM","year":"1995","journal-title":"Public Health Rep"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.01.004"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21443"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21515"},{"key":"e_1_2_5_6_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_5_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21781"},{"key":"e_1_2_5_8_2","article-title":"High resource hospitalizations among children with vaso\u2010occlusive crises in sickle cell disease","author":"Raphael JL","journal-title":"Pediatr Blood Cancer"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22069"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21408"},{"key":"e_1_2_5_11_2","unstructured":"SteinerCA MillerJL.Sickle cell disease patients in U.S. hospitals;2004; Report No.: HCUP statistical brief #21."},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10140"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-11-3758"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-233700"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7020.1600"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21676"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198606193142501"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.81.6.749"},{"key":"e_1_2_5_19_2","first-page":"220","article-title":"Comprehensive care in sickle cell disease: Its impact on morbidity and mortality","volume":"28","author":"Vichinsky EP","year":"1991","journal-title":"Semin Hematol"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e32834521dd"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21066"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23059"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199104113241506"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21977"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.378"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20180"},{"key":"e_1_2_5_27_2","first-page":"192","article-title":"Socioeconomic status and length of hospital stay in children with vaso\u2010occlusive crises of sickle cell disease","volume":"99","author":"Ellison AM","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21483"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21537"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406093302303"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60355-3"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21968"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21772"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006223422502"},{"key":"e_1_2_5_35_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.119593"},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807023390102"},{"key":"e_1_2_5_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08451.x"},{"key":"e_1_2_5_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199909000-00010"},{"key":"e_1_2_5_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/11.2.166"},{"key":"e_1_2_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.01.001"},{"key":"e_1_2_5_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.015"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.24065","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.24065","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.24065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:10:42Z","timestamp":1696896642000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.24065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,4]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,10]]}},"alternative-id":["10.1002\/pbc.24065"],"URL":"https:\/\/doi.org\/10.1002\/pbc.24065","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,4]]}}}