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Haematologica. 2017 Apr;102(4):626-636. doi: 10.3324/haematol.2016.153791. Epub 2017 Jan 19.

Risk factors for mortality in adult patients with sickle cell disease: a meta-analysis of studies in North America and Europe.

Author information

1
Department of Biostatistics, University of North Carolina, Chapel Hill.
2
Division of Cardiology, University of North Carolina, Chapel Hill.
3
Children's Hospital of Philadelphia.
4
Division of Hematology, The Ohio State University, Columbus.
5
Division of Hematology/Oncology, University of North Carolina, Chapel Hill.
6
Department of Medicine, Howard University, Washington, DC, USA.
7
Department of Medicine, University of Pittsburgh, PA, USA.
8
Division of Hematology/Oncology, University of North Carolina, Chapel Hill kataga@med.unc.edu.

Abstract

Although recent studies show an improved survival of children with sickle cell disease in the US and Europe, for adult patients mortality remains high. This study was conducted to evaluate the factors associated with mortality in adult patients following the approval of hydroxyurea. We first evaluated the association between selected variables and mortality at an academic center (University of North Carolina). Data sources were then searched for publications from 1998 to June 2016, with meta-analysis of eligible studies conducted in North America and Europe to evaluate the associations of selected variables with mortality in adult patients. Nine studies, combined with the UNC cohort (total n=3257 patients) met the eligibility criteria. Mortality was significantly associated with age (per 10-year increase in age) [7 studies, 2306 participants; hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.10-1.50], tricuspid regurgitant jet velocity 2.5 m/s or more (5 studies, 1577 participants; HR: 3.03; 95%CI: 2.0-4.60), reticulocyte count (3 studies, 1050 participants; HR: 1.05; 95%CI: 1.01-1.10), log(N-terminal-pro-brain natriuretic peptide) (3 studies, 800 participants; HR: 1.68; 95%CI: 1.48-1.90), and fetal hemoglobin (7 studies, 2477 participants; HR: 0.97; 95%CI: 0.94-1.0). This study identifies variables associated with mortality in adult patients with sickle cell disease in the hydroxyurea era.

PMID:
28104703
PMCID:
PMC5395103
DOI:
10.3324/haematol.2016.153791
[Indexed for MEDLINE]
Free PMC Article

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