Impact of hospitalization for vaso-occlusive crisis on health-related quality of life in children with sickle cell disease.

Abstract

Sickle cell disease (SCD) is characterized by vaso-occlusive crises (VOCs) that impair the health-related quality of life (HRQoL). The aim of this study is to evaluate the impact of hospitalization for VOCs on HRQoL in children with SCD over time. In this longitudinal cohort study, children aged 8-18years diagnosed with SCD at the Amsterdam UMC were included between 2012 and 2021. HRQoL was annually measured as part of standard care using the Pediatric Quality of Life Inventory. The impact of hospitalization for VOC on HRQoL was evaluated using linear mixed models 3, 6, 9, and 12months after hospitalization. The effect of frequency of hospitalization for VOC on HRQoL was evaluated over the last 12months. In total, 94 children with SCD were included with a median age of 11.8years (interquartile range [IQR]: 9-14). Thirty-seven patients (39%) had been hospitalized for a VOC. Hospitalization for VOC led to a decrease of 3.2-4.8 points in total HRQoL compared to patients without hospitalization, most pronounced 3months after hospitalization. Recurrent admission for VOC in the last 12months was associated with a decrease of 2.3 points in total HRQoL (p=.04). The most affected subscale was physical functioning. The adverse effects of hospitalization for VOC in children with SCD persist up to 12months after hospitalization. After hospitalization for VOC, extra attention and support for its negative impact on HRQoL are recommended. This study also underlines the importance of systematically measuring HRQoL, allowing clinicians to intervene accordingly.