Caring for children with sickle cell disease at the Robert-Debre Hospital,Paris. Evolution between 1992 and 1996

Aim. - In recent years, physicians at the Robert-Debre pediatric hospital i n Paris perceived an increase in activity linked to sickle cell disease car e. Our study had two objectives: first, to describe the evolution of care f or children with sickle cell disease in the hospital, then, if a heavier in tensity of care was shown, to try to investigate its causes. Methods and patients. - We conducted a retrospective study using two strate gies. On one hand, we compared the group of children followed up in 1992 wi th the group of children followed up in 1996 for their phenotype and hospit alizations (frequency, length of stay and type of complications), on the ot her hand, we described the course of complications and hospitalizations in the cohort of children followed from 1992 to 1996. Children were spotted th rough lists established by the 'Center far sickle cell disease: which coord inates the follow-up of all sickle cell patients in the hospital. Data came from the hospital's information system, and from all (medical, nursing, an d social) individual records. Results. - The major result of this study shows an increasing activity link ed to sickle cell disease care in this hospital.. multiplication of hospita lizations and increasing work load for the healthcare teams. This situation is due to a larger recruitment, a higher emergency hospitalization rate, a nd an increasing rate of complications among the sickle cell children. The children's ageing is part of the explanation. The work load for the healthc are team linked to each hospitalization has also grown, as shown by an incr easing rate of morphine prescription. (C) 2000 Editions scientifiques et me dicales Elsevier SAS.