Document Detail

The complete blood count and reticulocyte count--are they necessary in the evaluation of acute vasoocclusive sickle-cell crisis?
MedLine Citation:
PMID:  8853669     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the usefulness of the complete blood count (CBC) and the reticulocyte count in the evaluation of adult patients with acute vasoocclusive sickle-cell crisis (SCC) presenting to the ED. METHODS: A 2-part study was performed. Part 1 was retrospective chart review of patients with a sole ED diagnosis of acute SCC. Part 2 was a prospective evaluation of consecutive patients presenting in SCC. In both parts of the study, patients with coexisting acute disease were excluded. The remaining patients were divided into 2 groups: admitted and released. The mean values for white blood cell (WBC) count, hemoglobin (Hb) level, and reticulocyte count were compared. In Part 2, the change (delta) from the patient's baseline in WBC count, Hb level, and reticulocyte count also was determined. Data were analyzed by 2-tailed Student's t-test. RESULTS: Part 1: There was no difference between the admitted (n = 33) and the released (n = 86) groups in mean WBC count (p = 0.10), Hb level (p = 0.25), or reticulocyte count (p = 0.08). Part 2: There was no difference between the admitted (n = 44) and the released (n = 160) groups in mean Hb level (p = 0.88), reticulocyte count (p = 0.47), delta Hb level (p = 0.88), and delta reticulocyte count (p = 0.76). There was a difference in mean WBC counts (15.8 +/- 4.9 x 10(9)/L admitted vs 12.8 +/- 4.9 x 10(9)/L released, p = 0.003) and delta WBC counts (5.1 +/- 4.6 x 10(9)/L admitted vs 1.8 +/- 4.6 x 10(9)/L released, p < 0.002). CONCLUSION: Determination of the Hb level and the reticulocyte count do not appear useful in the evaluation of acute SCC in the ED. Admission decisions appear associated with elevations in the WBC count. Further study is required to determine the true value of the WBC count in such decisions.
B L Lopez; S K Griswold; A Navek; L Urbanski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  3     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-12-19     Completed Date:  1996-12-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  751-7     Citation Subset:  IM    
Jefferson Medical College, Philadelphia, PA, USA.
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MeSH Terms
Anemia, Sickle Cell / diagnosis*,  physiopathology
Blood Cell Count*
Leukocyte Count
Pain / etiology,  prevention & control
Prospective Studies
Reticulocyte Count*
Retrospective Studies

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