Sickle cell disease: a third of sufferers were admitted within 12 months.

Clinical bottom line (level 2c)

  1. Nearly a third of patients with sickle cell disease had an acute admission within 12 months. Most were due to painful crises.
  2. Less than a tenth of patients had a visceral sequestration within 12 months. Most of these patients were SS.
Brozovic et al: British Medical Journal 1987; 294: 1206-1208
Expires June 2003

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: haematology department of general hospital, UK

211 patients (aged ?, ?% male) sickle cell disease who resided in a city borough
Standard treatment was given- high fluid intake, antibiotics and analgesia.

100% followed for 12 months
Outcomes studied:
  • acute admission
  • visceral sequestration

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    acute admission 12 months 63/211 29.9%
    (23.7% to 36.0%)
    visceral sequestration 12 months 15/211 7.11%
    (3.64% to 10.6%)

    • There were 161 acute admissions in 63 patients. 147 admissions were for vaso-occlusive events (142 for painful crises), 11 were for infective or infection induced episode and 3 for reasons unconnected to sickle cell.
    • Visceral sequestration was only seen in SS (14) and S ß ° (1) patients.
    • 65% of the painful crises were experienced in the trunk.

    Citation

    1. Brozovic M, Davies SC, Brownell AI: Acute admissions of patients with sickle cell disease who live in Britain. British Medical Journal 1987; 294: 1206-1208
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer:

    Clinical Question.
    Patient sickle cell disease
    Intervention or Exposure prevalence
    Outcome admissions