Diallo Alioune Badara, Seck Moussa, Touré Sokhna Aissatou, Keita Mohamed, Bousso Elimane Seydi, Faye Blaise Félix, Diop Saliou
Hematology Department, Cheikh Anta Diop University, Dakar, Senegal.
Ouakam Military Hospital, Hematology Department, Cheikh Anta Diop University, Dakar, Senegal.
Anemia. 2024 Nov 21;2024:7143716. doi: 10.1155/anem/7143716. eCollection 2024.
Sickle cell emergencies are the most common cause of hospitalization for patients with sickle cell disease (SCD). Hospital readmissions represent a considerable financial burden for healthcare systems and increase patient morbidity and mortality. The aim of this study was to assess the prevalence and predictive factors of sickle cell emergencies readmission. We conducted a prospective, cross-sectional, descriptive, and analytical study over a 4-month period, including all adult patients admitted for an emergency related to SCD: vaso-occlusive crisis (VOC), acute chest syndrome (ACS), severe anemia, infections, priapism, and stroke. Readmission was considered when the patient returned to the emergency within a period of <30 days, either due to recurrence, persistence of the same complication, or the occurrence of another acute complication related to SCD. We recorded 151 sickle cell emergencies for 112 patients, representing 0.33 emergencies/month/patient. Fifty-eight cases of readmission were recorded, resulting in a readmission rate of 38.41%. Among these patients, 53 (91.37%) had two admissions, and 5 (8.62%) had three admissions. The median age of the patients was 28.41 years (16-70 years), and the sex ratio was 0.57. The SS sickle cell phenotype was predominant in 97 patients (86.61%). The reasons for readmission were VOC (82.75%), ACS (13.72%), and severe anemia (3.44%). The main factors that predicted readmission were the existence of professional activity, a low fetal hemoglobin (HbF) level, the existence of neutrophilia, lymphocytosis, and/or thrombocytosis ( values of 0.0084, 0.043, and 0.020 respectively). The 30-day readmission rate after a sickle cell emergency is high in our study. The main factors that predicted readmission were the existence of professional activity, a relatively low level of fetal Hb, the existence of neutrophilia, lymphocytosis, and/or thrombocytosis.
镰状细胞急症是镰状细胞病（SCD）患者住院治疗最常见的原因。再次入院给医疗系统带来了相当大的经济负担，并增加了患者的发病率和死亡率。本研究的目的是评估镰状细胞急症再入院的患病率及预测因素。我们在4个月的时间里进行了一项前瞻性、横断面、描述性和分析性研究，纳入了所有因与SCD相关的急症入院的成年患者：血管阻塞性危机（VOC）、急性胸综合征（ACS）、严重贫血、感染、阴茎异常勃起和中风。当患者在<30天内因复发、同一并发症持续存在或出现另一种与SCD相关的急性并发症而再次返回急诊时，即视为再次入院。我们记录了112例患者的151次镰状细胞急症，相当于每位患者每月0.33次急症。记录到58例再次入院病例，再入院率为38.41%。在这些患者中，53例（91.37%）有两次入院，5例（8.62%）有三次入院。患者的中位年龄为28.41岁（16 - 70岁），性别比为0.57。97例患者（86.61%）以SS镰状细胞表型为主。再次入院的原因是VOC（82.75%）、ACS（13.72%）和严重贫血（3.44%）。预测再次入院的主要因素是有职业活动、胎儿血红蛋白（HbF）水平低、存在中性粒细胞增多、淋巴细胞增多和/或血小板增多（相应值分别为0.0084、0.043和0.020）。在我们的研究中，镰状细胞急症后的30天再入院率很高。预测再次入院的主要因素是有职业活动、胎儿Hb水平相对较低、存在中性粒细胞增多、淋巴细胞增多和/或血小板增多。
