Presentation Details
| Emergency department utilization in a patient cohort with hemophilia: A Single Centre Experience Kelsey Uminski1, 2, Natalia Rydz1, 2, Dawn Goodyear1, 2. 1Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, AB, Canada.2Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program, Calgary, AB, Canada |
Abstract
Background: With the development of effective hemostatic agents, and the establishment of hemophilia treatment centers (HTCs), there has been a shift in hemophilia care away from the hospital and into the patient home. Furthermore, individuals with hemophilia are now experiencing age-related health challenges previously uncommon to their care, potentially resulting in increased emergency department (ED) utilization for non-hemophilia related issues. The objective of this study is to describe ED utilization among a patient cohort with hemophilia and characterize reasons for ED care. Methods: Adult patients with hemophilia A or B, of any severity, followed at the Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program were identified for study inclusion. ED health utilization data for each of the four hospital sites and two urgent care centers in Calgary, AB was obtained for the cohort, from 2014 through to 2022 from the electronic health record. Results: A total of 191 patients with hemophilia A and B were identified for study inclusion: 153 patients with hemophilia A and 38 patients with hemophilia B. A total of 393 ED visits occurred over the study period. Most ED visits were triaged per the Canadian Triage and Acuity Scale (CTAS) as Level 2 (36.8%) or Level 3 (36.8%) in which patients were identified as needing emergent care, and rapid medical intervention or urgent intervention, respectively. An additional 5.3% of visits were identified as CTAS Level 1, severely ill requiring resuscitation. The median ED length of stay was 3.45 hrs (IQR 3.12-3.95). Figure 1 demonstrates the proportion of ED visits associated with a hemophilia related diagnosis. Table 1 demonstrates the categories of discharge diagnoses for ED visits. Gastrointestinal, skin and soft tissue, and musculoskeletal diagnoses represented 13%, 9.2% and 8.4% of ED visit diagnoses, respectively. Conclusions: Our cohort of patients with hemophilia sought care in the ED for urgent and emergent indications. While hemophilia related presentations were observed, this represented a small proportion of total ED visits. This data provides a better understanding of the experience of patients with hemophilia in the ED and provides an opportunity to better understand evolving acute care needs in a contemporary hemophilia patient population.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.