{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:36:03Z","timestamp":1790771763923,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To determine whether patients with sickle cell disease (SCD) who present to the emergency department (ED) with vasoocclusive pain crises (VOC), and have coexisting mental health (MH) diagnoses, are more likely to have increased health care utilization and more frequent opioid administration compared with those without coexisting MH conditions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a retrospective study of patients aged 5 to 18 years with SCD who presented to a tertiary care ED with a primary complaint of VOC between January 1, 2013, and December 31, 2017. We excluded patients with sickle cell trait and without a pain management plan in the electronic medical record. Outcomes included ED length of stay (LOS), admission rate, and opioid administration in the ED. Morphine equivalents were used to standardize opioid dosing. Mann-Whitney <jats:italic toggle=\"yes\">U<\/jats:italic> and \u03c7<jats:sup>2<\/jats:sup> tests were used for univariate analysis. Multivariable logistic was performed for categorical and continuous outcomes, respectively, after adjusting for confounding factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We identified 978 encounters. We excluded 196 without a pain management plan and one with inaccurate ED LOS, resulting in 781 encounters (148 patients) for analysis. Coexisting MH diagnoses were present in 75.0% of encounters, with anxiety (83.0%) and depressive disorders (55.9%) being most common. Compared with SCD patients without coexisting MH diagnoses, those with coexisting MH diagnoses had significantly longer ED LOS (252 \u00b1 139 minutes vs 232 \u00b1 145 minutes, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03), longer median hospital LOS (1.4 \u00b1 3.2 days vs 0.3 \u00b1 2.4 days, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) in univariate analyses, but these differences were no longer significant in adjusted regression models. Patients with coexisting MH diagnoses had higher frequency of opioid administration in the ED (85.6% vs 71.4%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and higher odds of receiving opioids (adjusted odds ratio, 2.07; 95% confidence interval, 1.28\u20133.33).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Patients with SCD and coexisting MH diagnoses presenting with VOC have greater odds of receiving opioids compared with patients with SCD without coexisting MH diagnoses. Our results indicate a need for more MH resources in this vulnerable population and may help guide future management strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002322","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T16:57:54Z","timestamp":1608310674000},"page":"e664-e669","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Emergency Department Health Care Utilization and Opioid Administration Among Pediatric Patients With Sickle Cell Vasoocclusive Pain Crisis and Coexisting Mental Health Illness"],"prefix":"10.1097","volume":"38","author":[{"given":"Viviane Tchonang","family":"Leuche","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen J.","family":"Cutler","sequence":"additional","affiliation":[{"name":"Children's Minnesota Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen C.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Children's Minnesota, Minneapolis, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Jin","sequence":"additional","affiliation":[{"name":"Children's Minnesota Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly R.","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"S512","DOI":"10.1016\/j.amepre.2009.12.022","article-title":"Population estimates of sickle cell disease in the U.S","volume":"38","year":"2010","journal-title":"Am J Prev 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