Score of Glassberg et al for Predicting 30-Day ED Revisit for Pain in a Patient with Sickle Cell Anemia

Description

Glassberg et al developed a score for identifying a sickle cell anemia patient who is likely to revisit the Emergency Department (ED) for pain within 30 days. The authors are from Icahn School of Medicine at Mount Sinai, St. Joseph's Regional Medical Center in Paterson, New Jersey, and NYU College of Nursing.

Patient selection: sickle cell anemia with painful crisis due to vaso-occlusion.

Outcome: revisit for pain within 30 days

Parameters:

(1) insurance

(2) triage pain score (VAS scale from 0 to 10 on 10 cm scale)

(3) age in years

(4) opioid dose in IV morphine equivalent in mg

Parameter	Finding	Points
age	< 15 years	0
	>= 15 years	1
insurance	none	1
	not accepted at clinic	1
	accepted	0
triage pain score	0	0
	>= 1	1
opioid dose	0	0
	0.1 to 8 mg	1
	8.1 to 24 mg	2
	> 24 mg	3

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the more likely that the patient will revisit the ED for pain within 30 days.

• The authors used a score >= 4 to indicate high risk. The percent revisiting for 3 is similar to a score of 4, so >= 3 could also be used.

Score	Percent Revisit
0	< 5%
1	12-23%
2	12-26%
3	33-36%
4	35-38%
5	54-56%
6	85-100%

Perfomance:

• The area under the ROC curve was 0.75.

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Score of Glassberg et al for Predicting 30-Day ED Revisit for Pain in a Patient with Sickle Cell Anemia

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