Frequency of emergency medical service utilization in sickle cell disease patients in Brazil

Authors

DOI:

https://doi.org/10.15517/2tyfhj56

Keywords:

Sickle Cell Disease, Emergency Medical Services, Hospitalization

Abstract

Introduction: Sickle cell disease (SCD) is a genetic condition with serious complications, frequently necessitating emergency medical attention. This study aimed to analyze the frequency of emergency department visits among patients with sickle cell disease in Brazil. Materials and Methods: This quantitative, retrospective study analyzed 116,199 emergency medical records from 18,381 SCD patients between 2006 and 2022. A zero-truncated Poisson regression model was employed to assess regional heterogeneity in the search for these services. Results: The findings indicated that patients in the Northeast, North, and Southeast regions had a lower frequency of emergency hospitalizations compared to those in the Central-West. No significant difference was observed in the South. Additionally, male and elderly patients sought emergency care with greater frequency. Conclusions: These results highlight significant regional disparities and the influence of sex and age on emergency service utilization among SCD patients in Brazil. This information is crucial for planning public health strategies and improving care for this vulnerable population, facilitating the implementation of more effective preventive measures and health policies.

Downloads

Download data is not yet available.

References

Adam, S. S., Flahiff, C. M., Kamble, S., Telen, M. J., Reed, S. D., & De Castro, L. M. (2017). Depression, quality of life, and medical resource utilization in sickle cell disease. Blood Advances, 1(23), 1983–1992. https://doi.org/10.1182/bloodadvances.2017006940 DOI: https://doi.org/10.1182/bloodadvances.2017006940

Agência Nacional de Vigilância Sanitária. (2002). Manual de diagnóstico e tratamento de doenças falciformes. ANVISA. https://bvsms.saude.gov.br/bvs/publicacoes/anvisa/diagnostico.pdf

Amrhein, V., Greenland, S., & McShane, B. (2019). Scientists rise up against statistical significance. Nature, 567(7748), 305–307. https://doi.org/10.1038/d41586-019-00857-9 DOI: https://doi.org/10.1038/d41586-019-00857-9

Badawy, S. M., Beg, U., Liem, R. I., Chaudhury, S., & Thompson, A. A. (2021). A systematic review of quality of life in sickle cell disease and thalassemia after stem cell transplant or gene therapy. Blood Advances, 5(2), 570–583. https://doi.org/10.1182/bloodadvances.2020002948 DOI: https://doi.org/10.1182/bloodadvances.2020002948

Bailey, M., Abioye, A., Morgan, G., Burke, T., Disher, T., Brown, S., Bonner, A., Herquelot, E., Lamarsalle, L., & Raguideau, F. (2019). Relationship between Vaso-Occlusive Crises and Important Complications in Sickle Cell Disease Patients. Blood, 134(Supplement 1), 2167. https://doi.org/10.1182/blood-2019-131721 DOI: https://doi.org/10.1182/blood-2019-131721

Barros, G. dos S., Leal, C. V. F., Leite, L. A. C., Fujimoto, D. E., & Cançado, R. D. (2024). Real-world evidence of the burden of sickle cell disease: a 5-year longitudinal study at a Brazilian reference center. Hematology, Transfusion and Cell Therapy, 46(2), 161–166. https://doi.org/10.1016/j.htct.2023.10.001 DOI: https://doi.org/10.1016/j.htct.2023.10.001

Cameron, B. F., Christian, E., Lobel, J. S., & Gaston, M. H. (1983). Evaluation of clinical severity in sickle cell disease. Journal of the National Medical Association, 75(5), 483. https://pmc.ncbi.nlm.nih.gov/articles/PMC2561539/

Cançado, R. D., Costa, F. F., Lobo, C., Migliavaca, C. B., Falavigna, M., Souza Filho, H. C. R., Bueno, C. T., & Silva-Pinto, A. C. (2023). Estimated mortality rates of individuals with sickle cell disease in Brazil: real-world evidence. Blood Advances, 7(15), 3783–3792. https://doi.org/10.1182/bloodadvances.2022008938 DOI: https://doi.org/10.1182/bloodadvances.2022008938

Caselli, P. F. B., Di Lorenzo Oliveira, C., Gomes, I., Salomon, T., Sabino, E. C., Capuani, L., et al. (2025). Mortality from sickle cell disease in Brazil. PLOS Global Public Health, 5(7), e0002066. https://doi.org/10.1371/journal.pgph.0002066 DOI: https://doi.org/10.1371/journal.pgph.0002066

Colombatti, R. (2023). Standardizing elements of care in pediatric sickle cell disease centers: The road toward health equity. Pediatric Blood & Cancer, 70(1), e30078. https://doi.org/10.1002/pbc.30078 DOI: https://doi.org/10.1002/pbc.30078

Cordovil, K., Tassinari, W., Oliveira, R. de V. C. de, & Hökerberg, Y. (2023). Social inequalities in the temporal trend of mortality from sickle cell disease in Brazil, 1996–2019. Cadernos de Saúde Pública, 39, e00256421. https://doi.org/10.1590/0102-311xen256421 DOI: https://doi.org/10.1590/0102-311xen256421

Costa, F. F., Conran, N., & Fertrin, K. Y. (2001). Anemia falciforme. In M. A. Zago, R. P. Falcão, & R. Pasquini (Eds.), Hematologia. Fundamentos e Prática (1a ed., pp. 195–216). Rio de Janeiro. https://edisciplinas.usp.br/pluginfile.php/2823593/mod_resource/content/1/Anemia%20falciforme.pdf

DeBaun, M. R., Jordan, L. C., King, A. A., Schatz, J., Vichinsky, E., Fox, C. K., McKinstry, R. C., Telfer, P., Kraut, M. A., Daraz, L., Kirkham, F. J., & Murad, M. H. (2020). American Society of Hematology 2020 guidelines for sickle cell disease: Prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. Blood Advances, 4(8), 1554–1588. https://doi.org/10.1182/bloodadvances.2019001142 DOI: https://doi.org/10.1182/bloodadvances.2019001142

Dély, N. S. V., Alvarez, O. A., Dor, V. J., & Lerebours, E. (2019). Comparison of Clinical Evolution of Children with Sickle Cell Disease before and after Treatment with Hydroxyurea at Saint Damien Hospital, Tabarre-Haiti, 2013-2018. Blood, 134(Supplement 1), 2306–2306. https://doi.org/10.1182/blood-2019-124105 DOI: https://doi.org/10.1182/blood-2019-124105

Dexter, D., & McGann, P. T. (2023). Hydroxyurea for children with sickle cell disease in sub‐Saharan Africa: A summary of the evidence, opportunities, and challenges. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 43(5), 430–441. https://doi.org/10.1002/phar.2792 DOI: https://doi.org/10.1002/phar.2792

Jiao, B., Johnson, K. M., Ramsey, S. D., Bender, M. A., Devine, B., & Basu, A. (2023). Long-term survival with sickle cell disease: A nationwide cohort study of Medicare and Medicaid beneficiaries. Blood Advances, 7(13), 3276–3283. https://doi.org/10.1182/bloodadvances.2022009202 DOI: https://doi.org/10.1182/bloodadvances.2022009202

Kato, G. J., Steinberg, M. H., & Gladwin, M. T. (2017). Intravascular hemolysis and the pathophysiology of sickle cell disease. Journal of Clinical Investigation, 127(3), 750–760. https://doi.org/10.1172/JCI89741 DOI: https://doi.org/10.1172/JCI89741

Manwani, D., & Frenette, P. S. (2013). Vaso-occlusion in sickle cell disease: Pathophysiology and novel targeted therapies. Blood, 122(24), 3892–3898. https://doi.org/10.1182/blood-2013-05-498311 DOI: https://doi.org/10.1182/blood-2013-05-498311

Menezes Neto, O. A. de. (2019). Aspectos imunohematológicos dos pacientes com anemia falciforme e a influência da hemoglobina S na distribuição linfocitária [Dissertação de Mestrado]. Universidade Federal de Sergipe. https://ri.ufs.br/handle/riufs/13080

Ministério da Saúde, Secretaria de Atenção à Saúde, & Departamento de Atenção Hospitalar. (2015). Doença falciforme: Diretrizes básicas da linha de cuidado. Ministério da Saúde. Governo do Brasil https://bvsms.saude.gov.br/bvs/publicacoes/doenca_falciforme_diretrizes_basicas_linha_cuidado.pdf

Ministério da Saúde. (2023). Boletim Epidemiológico Saúde da População Negra, Número Especial (Vol. 1). Governo do Brasil. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/especiais/2023/boletim-epidemiologico-saude-da-populacao-negra-numero-especial-vol-1-out.2023/view

Nasiri, A., & Alahmari, A. D. (2023). The Quality of Life of Sickle Cell Disease Patients in Saudi Arabia 2023. Blood, 142(Supplement 1), 5310–5310. https://doi.org/10.1182/blood-2023-188614 DOI: https://doi.org/10.1182/blood-2023-188614

Obeagu, E. I. (2024). Influence of Hemoglobin Variants on Vaso-Occlusive Phenomena in Sickle Cell Anemia: A Review. International Journal of Medical Sciences and Pharma Research, 10(2), 54–59. https://doi.org/10.22270/ijmspr.v10i2.104 DOI: https://doi.org/10.22270/ijmspr.v10i2.104

Ohara, D. G., Ruas, G., Castro, S. S., Martins, P. R. J., & Walsh, I. A. P. (2012). Musculoskeletal pain, profile and quality of life of individuals with sickle cell disease. Brazilian Journal of Physical Therapy, 16(5), 431–438. https://doi.org/10.1590/S1413-35552012005000043 DOI: https://doi.org/10.1590/S1413-35552012005000043

R Core Team. (2024). R: The R Project for Statistical Computing. R Foundation for Statistical Computing. https://www.r-project.org/

Riley, C., Kraft, W. K., & Miller, R. (2024). Hydroxyurea in the sickle cell disease modern era. Expert Review of Clinical Pharmacology, 17(9), 777–791. https://doi.org/10.1080/17512433.2024.2390915 DOI: https://doi.org/10.1080/17512433.2024.2390915

Sundd, P., Gladwin, M. T., & Novelli, E. M. (2019). Pathophysiology of Sickle Cell Disease. Annual Review of Pathology: Mechanisms of Disease, 14(1), 263–292. https://doi.org/10.1146/annurev-pathmechdis-012418-012838 DOI: https://doi.org/10.1146/annurev-pathmechdis-012418-012838

Tewari, S., Brousse, V., Piel, F. B., Menzel, S., & Rees, D. C. (2015). Environmental determinants of severity in sickle cell disease. Haematologica, 100(9), 1108–1116. https://doi.org/10.3324/haematol.2014.120030 DOI: https://doi.org/10.3324/haematol.2014.120030

Udeze, C., Maruszczyk, K., Atter, M., & Lopez, A. (2022). P1704: Projected lifetime economic burden of severe sickle cell disease in the United States. HemaSphere, 6(S5), 1585–1586. https://doi.org/10.1097/01.HS9.0000849672.40887.0f DOI: https://doi.org/10.1097/01.HS9.0000849672.40887.0f

Visão geral da anemia hemolítica—Hematologia e oncologia. (2024). Manuais MSD Edição para Profissionais. https://www.msdmanuals.com/pt-br/profissional/hematologia-e-oncologia/anemias-causadas-por-hem%C3%B3lise/vis%C3%A3o-geral-da-anemia-hemol%C3%ADtica.

Yee, T. W., Stoklosa, J., & Huggins, R. M. (2015). The VGAM Package for Capture-Recapture Data Using the Conditional Likelihood. Journal of Statistical Software, 65(5). https://doi.org/10.18637/jss.v065.i05 DOI: https://doi.org/10.18637/jss.v065.i05

Zago, M., Gualandro, S., Domingos, C., Saad, S., Alberto, F., Costa, F., & Ramalho, A. (2002). Manual de diagnóstico e tratamento de doenças falciformes. ANVISA. https://bvsms.saude.gov.br/bvs/publicacoes/anvisa/diagnostico.pdf

Published

2026-05-20