Vitamin D supplementation and pain-related emergency department visits in children with sickle cell disease |
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Affiliation: | 1. Columbia University School of Nursing, New York, NY, United States;2. College of Dental Medicine, Columbia University Medical Center, New York, NY, United States;3. Mailman School of Public Health, New York, NY, United States;4. Department of Biomedical Informatics, Columbia University Medical Center, New York, NY, United States;5. Department of Pediatrics, Columbia University Medical Center, New York, NY, United States;6. Department of Psychiatry, Columbia University Medical Center, New York, NY, United States;7. New York Presbyterian Hospital, New York, NY, United States;8. Community Health Worker Network of New York City, United States;9. Department of Pediatrics, Albert Einstein Medical School and Montefiore Hospital, NY, NY, United States;1. Center for Cancer and Blood Disorders, Children''s National Medical Center, Washington, D.C. 20010, United States;2. Division of Critical Care Medicine, Children''s National Medical Center, Washington, D.C. 20010, United States;3. Division of Biostatistics and Study Methodology, Children''s National Medical Center, Washington, D.C. 20010, United States;4. Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, D.C. 20037, United States |
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Abstract: | ObjectivesSickle cell disease (SCD) is the most prevalent inherited hematological disorder and affects 100,000 individuals in the United States. Pain is the most common cause of emergency department (ED) visits in the SCD population, which profoundly affects quality of life. Vitamin D supplementation is a potential target for reducing pain. Thus, the goal of the present study was to identify the prevalence of vitamin D deficiency and explore the relationship between vitamin D supplementation and ED visits in pediatric patients with SCD.DesignWe conducted a retrospective chart review of 110 patients with SCD aged 8–16 years who had at least one ED visit for SCD pain during the 6-year study period. Patients were categorized into three vitamin D supplementation groups: patients who did not receive supplementation, patients supplemented with 25-hydroxyvitamin D levels (< 30 ng/mL), and patients supplemented with at least one sufficient 25-hydroxyvitamin D level (≥ 30 ng/mL).ResultsOverall, 45 % of patients were vitamin D deficient. Only 20 % of patients had sufficient vitamin D levels. This number increased to 55 % when examining only patients who did not receive vitamin D supplementation. For patients supplemented with vitamin D, the number of ED visits was significantly lower after they reached the sufficient range (≥ 30 ng/mL), p = 0.03.ConclusionsOur findings indicate that reductions in the number of pain-related ED visits may be achieved by normalizing 25-hydroxyvitamin D levels with supplementation. In addition, findings highlight the need for screening and vitamin D supplementation being incorporated into routine care for pediatric patients with SCD. |
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Keywords: | Sickle cell disease Vitamin D deficiency Vitamin D supplementation Pain Emergency department |
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