MORTALITY RISK FACTORS IN HOSPITALISED LATE ADOLESCENT AND ADULT SICKLE CELL DISEASE PATIENTS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 2
Abstract
BACKGROUND Odisha state of India has a high burden of Sickle Cell Disease (SCD) with high morbidity and mortality. Survival among patients with SCD has improved with the use of Hydroxyurea (HU) and better healthcare facilities, but is still below that of the general population. Morbidity and mortality in SCD is determined by various environmental factors in addition to genetic modifiers. MATERIALS AND METHODS Confirmed cases of SCD admitted to the Department of Medicine were included in the study. Factors that may lead to death were evaluated from history, clinical manifestations and laboratory investigations. Statistical analysis was done using statistical tool EPI INFO by Centre for Disease Control, USA, and Statistical Package for Social Sciences (SPSS) for windows software. A p value of <0.05 was considered significant. Comparison was made between those who survived and those who died. RESULTS Among a total number of 147 SCD patients studied, death occurred in 46 number of cases. Among these deaths, vaso-occlusive crisis was found in 38 number of cases (82.6%), infection in 20 cases (43.47%) and acute chest syndrome in 4 cases (8.69%) showing overlapping complications. Various precipitating factors associated with mortality include physical exertion (43.48%), cold exposure (4.35%), discontinuation of HU (56.52%) and pregnancy in 1 case. Lower level of oxygen saturation (SpO2) (90.19 ± 7.4%), higher heart rate (97.21 ± 20.93), lower haemoglobin concentration (6.45 ± 1.76 g/dL), decreased platelet count (1.73 ± 0.96 lac/µL) and higher serum creatinine (2.08 ± 2.26 mg/dL) at the time of presentation were found to be significantly associated with mortality in patients with SCD. CONCLUSION In addition to the conventional precipitating factors, discontinuation of HU was found to be an important factor associated with mortality. However, larger number of deaths in SCD must be studied to test the strength of this association.
Authors and Affiliations
Pradeep Kumar Mohanty, Srinibas Meher
Keywords
Related Articles
- EP ID EP448604
- DOI 10.18410/jebmh/2018/30
- Views 64
- Downloads 0
SUICIDAL HANGING IN URBAN YOUTH: A PROSPECTIVE STUDY
BACKGROUND: Suicide is among the top three causes of death among youth worldwide. Hanging is among the most common modes of suicide. OBJECTIVES: The purpose of this prospective study is to determine the Suicidal hanging...
CONJUNCTIVAL AND TEAR FILM CHANGES IN PATIENTS OF DRY EYE USING PVA+POVIDONE WITH AND WITHOUT PRESERVATIVES- A CLINICOCYTOLOGICAL STUDY
BACKGROUND To study the conjunctival and tear film changes in patients of dry eye using PVA + Povidone with and without preservatives- A clinicocytological study. MATERIALS AND METHODS A prospective, randomised, case-con...
CLINICAL STUDY OF PAEDIATRIC TUBERCULOSIS WITH REFERENCE TO ADENOSINE DEAMINASE LEVEL IN COMPARISON WITH DNA PCR FOR DIAGNOSIS OF MYCOBACTERIUM TUBERCULOSIS
BACKGROUND To study the clinical profile of paediatric tuberculosis with reference to adenosine deaminase level in comparison with DNA PCR for diagnosis of mycobacterium tuberculosis. Tuberculosis is still a leading caus...
DIABETES & HYPERTENSION: THE SIAMESE TWINS
Globally type 2 diabetes is in increasing trend with projected 366 million by 2030. The number of adults with hypertension is predicted to increase by 60% to a total of 1.56 billion people by 2025. 70% patients with DM h...
NEW MINIMALLY-INVASIVE METHOD OF TREATING INTRAMEDULLARY CHRONIC OSTEOMYELITIS OF LONG BONES- A PRELIMINARY REPORT
BACKGROUND The classical method of treatment of chronic osteomyelitis with sequestrum needs saucerization and sequestrectomy which become quite difficult when small sequesrtrae are spread over a long span in medullary ca...