Vaso-occlusive crisis pain intensity, frequency, and duration: which best correlates with health-related quality of life in adolescents and adults with sickle cell disease?

Author:

McClish Donna1,Okhomina Victoria1,Pascale Angela2,Valrie Cecelia23,Sisler India4,Villella Anthony5,Smith Wally6

Affiliation:

1. Biostatistics and

2. Psychology, Virginia Commonwealth University, Richmond, VA, United States

3. VCU Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, United States

4. Division of Pediatric Haematology and Oncology, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, United States

5. Children's Hospital of King's Daughter, Norfolk, VA, United States

6. Division of General Internal Medicine, Department of Medicine, Virginia Commonwealth University, Richmond, VA, United States

Abstract

Abstract In a cross-sectional analysis of baseline data from a randomized clinical trial, we studied 198 adolescents and adults aged 15+ with sickle cell disease. Interest was in assessing the relative strengths of the relationship of vaso-occlusive crisis (VOC) pain domains of intensity, frequency, and duration, with health-related quality of life (HRQOL). Variation in psychosocial, physical function, and pain expression domains of HRQOL was partially explained by frequency, intensity, and duration of VOC pain, separately and together, over and above differences in age, sex, genotype, and organ system damage. However, no single domain measure accounted for more than an additional partial R 2 of 12.5% alone. Vaso-occlusive crisis pain frequency explained the most variation, when simultaneously considering VOC intensity and duration, except for stiffness, where duration was most predictive. Yet VOC pain intensity, and even VOC duration, also contributed to variability in HRQOL. We recommend that for most purposes, because all 3 VOC pain domains contribute to variability in HRQOL, all 3 domains should be assessed and interventions should be targeted to improve all 3 domains to maximize HRQOL outcomes (Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02197845).

Funder

NHLBI Division of Intramural Research

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Anesthesiology and Pain Medicine,Neurology (clinical),Neurology

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