Severity Classification of Painful Crises in Sickle Cell Disease

 

Criteria of Charache et al for severe painful crises:

(1) >= 3 acute painful episodes per year

(2) episodes last > 4 hours

(3) pain control requires administration of parenteral opioid analgesic

(4) usually treated at Emergency Department or other medical facility

 

The location of care depends on:

(1) familiarity of the patient and family with painful crises

(2) access to appropriate analgesics

(3) access to health care

(4) severity of concurrent disease that triggered the episode

Pain Intensity (on a 10 cm VAS scale)	Analgesia Required	Other Features	Severity
0 to 3.9	NSAIDS	NA	mild
4 to 6	higher doses NSAIDS, oral opioids	NA	moderate
6.1 to 10	parenteral narcotics	therapy in ED or hospital, duration > 4 hours	severe

 

Interference with work or activities of daily living can also be used to grade pain (see Chapter 37, hemophilic arthropathy).