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West Indian Med J. 2014 Dec;63(7):711-6. doi: 10.7727/wimj.2014.012. Epub 2015 Mar 5.

Clinical Factors Associated with Morbidity and Mortality in Patients Admitted with Sickle Cell Disease.

Author information

1
Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.
2
Tropical Medicine Research Institute (Sickle Cell Unit), The University of the West Indies, Kingston 7, Jamaica, West Indies.
3
Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies.
4
Department of Pathology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
5
Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies. michael.lee@uwimona.edu.jm.

Abstract

OBJECTIVE:

To determine the clinical factors associated with the length of hospitalization and mortality in patients with sickle cell disease (SCD).

METHODS:

All patients with SCD admitted to the medical wards of the University Hospital of the West Indies, Jamaica, over a five-year period, January 1 to December 31, 2010, were reviewed. Data were extracted from hospital charts and comprised demographic and clinical information, investigations, interventions, duration of stay, pathological data and outcomes.

RESULTS:

There were 105 patients reviewed; 84% were genotype Hb SS. Females accounted for 59% and males 41%. Overall mean age was 32.5 years (SD 13.7, range 12-66 years). The mean length of hospitalization was 10.2 days (SD 10.9, range 1-84 days). The main admission diagnoses were painful crisis, acute chest syndrome, severe anaemia, sepsis, hepatic sequestration, congestive cardiac failure and renal failure. The mean value for the following laboratory investigations were: haemoglobin 7.7 g/dL (SD 2.8), total white blood cell count 21.7 x 109/L (SD 14.2), platelet count 320 x 109/L (SD 191.9), blood urea 9.8 mmol/L (SD 11.9) and serum creatinine 198 umol/L (SD 267.9). Medical interventions included: blood transfusions in 20.9%, 55% received antibiotics and 74% received narcotic analgesia. There were 40 deaths with four autopsies done. The mortality rate for SCD was 38%. There were 189 repeat SCD admissions.

CONCLUSION:

Sickle cell disease still carries a high morbidity and mortality in patients admitted to hospital. Recurrent admissions are a concern, as they impact on patient's morbidity and quality of life.

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