Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Ann Emerg Med. 2020 Sep;76(3S):S28-S36. doi: 10.1016/j.annemergmed.2020.08.009.
We provide an updated assessment of trends in sickle cell disease (SCD)-related mortality, a significant source of mortality in the United States among black persons, using 1979 to 2017 US mortality data.
SCD-related deaths were identified with International Classification of Diseases codes. Because SCD-related death is rare in other races, the analysis focused on black decedents. Age-specific and average annual SCD-related death rates were calculated. Causes of death codes were categorized into 20 groups relevant to SCD outcomes. SCD-related deaths were compared with non-SCD-related deaths after matching on race, sex, age group, and year of death.
There were 25,665 SCD-related deaths reported among blacks in the United States from 1979 through 2017. During that period, the annual SCD-related death rate declined in children and increased in adults, and the median age at death increased from 28 to 43 years. Acute causes of death, such as infection and cerebrovascular complications, were more common in younger age groups. Chronic complications were more common in adults. SCD-related deaths were more likely to be related to acute cardiac, pulmonary, and cerebrovascular complications; acute infections; and chronic cardiac and pulmonary complications and renal disorders; and less likely to be related to drug overdose and chronic infections than non-SCD-related deaths.
These data indicate SCD-related deaths are now more likely to be related to chronic complications of the disease than to acute complications. More research regarding prevention and treatment of chronic complications of SCD is necessary because persons with SCD are living longer.
我们利用 1979 年至 2017 年美国死亡率数据，对与镰状细胞病（SCD）相关的死亡率趋势进行了最新评估，这是美国黑人死亡率的一个重要来源。
使用国际疾病分类代码确定与 SCD 相关的死亡。由于其他种族中 SCD 相关死亡较为罕见，因此该分析主要集中在黑人死者身上。计算了特定年龄和平均年 SCD 相关死亡率。将死因代码分为与 SCD 结果相关的 20 组。在按种族、性别、年龄组和死亡年份匹配后，将 SCD 相关死亡与非 SCD 相关死亡进行比较。
1979 年至 2017 年期间，美国共有 25665 例黑人死于 SCD。在此期间，儿童的 SCD 相关死亡率逐年下降，而成年人的 SCD 相关死亡率则逐年上升，死亡时的中位年龄从 28 岁增加到 43 岁。急性死因，如感染和脑血管并发症，在年龄较小的人群中更为常见。慢性并发症在成年人中更为常见。SCD 相关死亡更可能与急性心脏、肺部和脑血管并发症、急性感染以及慢性心脏和肺部并发症和肾脏疾病有关；而与非 SCD 相关死亡相比，与药物过量和慢性感染的关系则较小。
这些数据表明，SCD 相关死亡现在更可能与疾病的慢性并发症有关，而不是与急性并发症有关。由于 SCD 患者的寿命延长，因此需要对 SCD 慢性并发症的预防和治疗进行更多研究。
