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    
Abstract/OtherAbstract:
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.
Authors:
B L Lopez; S K Griswold; A Navek; L Urbanski
Related Documents :
9933139 - Limited erythropoietic response to combined treatment with recombinant human interleuki...
10807769 - Bone marrow transplantation versus periodic prophylactic blood transfusion in sickle ce...
7446549 - The liver in sickle cell disease. a clinicopathologic study of 70 patients.
9537279 - Exchange transfusion as an adjunct to the treatment of severe falciparum malaria.
15014899 - Aneurysmatic dilatation of ascending aorta in a patient with beta-thalassemia and a pse...
8516039 - Transfusional hemosiderosis in sickle cell anemia: another cause of an echogenic pancreas.
12106929 - Early dysfunction and long-term improvement in endothelium-dependent vasodilation in th...
23611579 - Long-term safety of dichloroacetate in congenital lactic acidosis.
24673369 - Asymptomatic elevation of creatine kinase in patients with hyponatremia.
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    
Affiliation:
Jefferson Medical College, Philadelphia, PA, USA. lopezb@jeflin.tju.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anemia, Sickle Cell / diagnosis*,  physiopathology
Blood Cell Count*
Emergencies
Female
Hemoglobinometry
Humans
Leukocyte Count
Male
Pain / etiology,  prevention & control
Prospective Studies
Reticulocyte Count*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Informed consent for medical research: common discrepancies and readability.
Next Document:  Comparison of hyperbaric oxygen and dapsone therapy for loxosceles envenomation.