Evidence map›Paper›PMID 32770992›Full record

ArticleBMC pediatrics2020

The risk of acute events among patients with sickle cell disease in relation to early or late initiation of care at a specialist center: evidence from a retrospective cohort study.

Angela Edna Rankine-Mullings, Twila Mae Logan, Lesley-Gaye King, Colette Andrea Cunningham-Myrie, Clive Robert Scott, Jennifer Marcelle Knight-Madden

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Hydroxyurea (hydroxycarbamide) for sickle cell disease.The Cochrane database of systematic reviews · 2022
    Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Angela Edna Rankine-MullingsSickle Cell Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica. angela.rankinemullings@uwimona.edu.jm.
Twila Mae LoganMona School of Business and Management, University of the West Indies, Kingston, Jamaica.
Lesley-Gaye KingSickle Cell Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica.
Colette Andrea Cunningham-MyrieDepartment of Community Health & Psychiatry, University of the West Indies, Kingston, Jamaica.
Clive Robert ScottMona School of Business and Management, University of the West Indies, Kingston, Jamaica.
Jennifer Marcelle Knight-MaddenSickle Cell Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica.
University of the West Indies · JMUniversity of the West Indies System · JM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe greatest disease burden of sickle cell disease occurs early in life. Understanding factors that reduce disease related events in this period is therefore important. Hence, we assessed the impact of early care at a specialist center on the incidence of acute events during the first five years.

methodsThis was a retrospective cohort study among Jamaican children with sickle cell disease. Medical records of patients born January, 2004 to December, 2009, who were registered at the Sickle Cell Unit, a specialist care facility, were abstracted for dates of initiation to care, first occurrence and frequency of the outcomes of interest (vaso-occlusive crises, acute splenic sequestration, acute chest syndrome, and infection). Patients were classified according to whether initiation of care was before (early) or after 5 months of age (late). Using standardized t-tests, χ2 tests, and a multiple-failure survival analysis the rates of acute events between groups were compared.

resultsOf the total study group (n= 290), homozygous sickle cell disease accounted for 97% and 95% of the early (n=113) and late groups (n=177) respectively. The mean age of presentation in the early and late group was 0.2 and 2.3 years (p<0.01), with a mean length of follow-up of 5.2 and 3.2 years respectively (p<0.01). Vaso-occlusive crisis (n=880) and acute chest syndrome (n= 571) together accounted for 91.6% of the total number of events (n=1584). The risk of vaso-occlusive crisis and acute chest syndrome (among patients who presented with these acute events) was significantly higher in the "late" group, by 43% (Incidence rate ratio, (IRR) = 1.43, p<0.001); 95% CI (1.18-1.72) and 40% (IRR=1.40. p=0.002), 95% CI (1.12-1.75) respectively compared to "early" group. There was no difference in risk between groups for acute splenic sequestration and infection among persons presenting with these events.

conclusionThe risk of acute events in children with sickle cell disease exposed to early care at a specialist care is significantly less. Therefore, widespread screening with rapid referral to a specialist center stands to reduce substantial morbidity in Jamaica and other regions with high prevalence of sickle cell disease.

Indexed as

Acute Chest SyndromeAnemia, Sickle CellChildChild, PreschoolHomozygoteHumansInfantRetrospective StudiesSpecializationAcute chest syndromeAcute splenic sequestrationPenicillin prophylaxisRed blood cell disorderSickle cell disease

Identifiers

PMID32770992
PMCPMC7414688
OpenAlexW3048338546

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.