Because of the trend of enhanced out-patient management of patients with sickle cell disease to obviate hospitalization, we examined the value of a simple, inexpensive test, the erythrocyte sedimentation rate (ESR). The hypothesis was that the ESR could help determine which patients with sickle cell disease needed in-patient hospitalization for further observation and management, and which ones could be managed as out-patients. Forty pediatric patients with sickle cell disease who came to the Emergency Department (ED), or the Comprehensive Sickle Cell Program with a variety of complaints had ESR values obtained along with CBC's at presentation and between 48-72 hours after. These values were obtained independent of admission or disposition home. The ESR was found to be significantly higher at presentation and at 48-72 hours in those patients who went on to develop illness that required hospitalization for presumptive infection vs. those with painful crisis. (p value: <.05 at presentation, p value <.0005 at 48-72 hours).Table

Table 1
Full size table

The ESR, although non specific, can be used as an adjunct to standard practice guidelines in deciding which patients need hospitalization.

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