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Trends, Predictors, and Outcomes of Critically Ill Patients With Sickle Cell Disease in the United States

Year: 2025

Type: article

Abstract: ABSTRACT Introduction Despite recent advances in sickle cell disease (SCD) research and management, there remains very limited information available on critically ill SCD patients requiring intensive care units (ICUs). Methods The National Inpatient Sample was queried using the International Classification of Diseases codes to identify critically ill patients with SCD requiring ICU admission. These patients were further stratified into those with and without adverse clinical events (ACEs). The study outcomes were the incidence of acute chest syndrome, cardiac arrest, hemodialysis, sepsis, shock, and transfusion. Results Of 5941 patients admitted to the ICU, 2826 (47.6%) had ACE. Patients with ACE were likely to be older, male, white, rural, and have higher comorbidities. The prevalence of ICU admission increased by 126% (p < 0.01). The predictors of ACE included male sex, older age, coronary artery disease, heart failure, renal failure, and two or more comorbidities. Patients with ACE were more likely to have cardiac arrest, hemodialysis, sepsis, and shock (all p < 0.01). Conclusion There has been an increase in the prevalence of critically ill SCD patients requiring ICU care, with subsequent morbidity and mortality. Further research is needed to understand the underlying factors that drive these observed trends and increase mortality rates. Trial Registration The authors have confirmed clinical trial registration is not needed for this submission.

Source: eJHaem

DOI: 10.1002/jha2.70111

Authors: Tochukwu Nzeako, Olayemi Adeniran, Saranjeet Kaur, Shreya Singh, Jen Wang, Ammar Alzoubi