Nzeako Tochukwu, Adeniran Olayemi, Kaur Saranjeet, Singh Shreya, Wang Jen, Alzoubi Ammar
Department of Internal Medicine Christiana Care Hospital Newark Delaware USA.
Department of Cardiovascular Diseases SUNY Downstate Health Sciences University Brooklyn New York USA.
EJHaem. 2025 Aug 13;6(4):e70111. doi: 10.1002/jha2.70111. eCollection 2025 Aug.
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).
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.
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% ( < 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 < 0.01).
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.
The authors have confirmed clinical trial registration is not needed for this submission.
尽管镰状细胞病（SCD）的研究和管理最近取得了进展，但关于需要重症监护病房（ICU）的重症SCD患者的可用信息仍然非常有限。
使用国际疾病分类代码查询全国住院患者样本，以识别需要入住ICU的重症SCD患者。这些患者进一步分为有和没有不良临床事件（ACE）的患者。研究结果包括急性胸综合征、心脏骤停、血液透析、败血症、休克和输血的发生率。
在入住ICU的5941名患者中，2826名（47.6%）发生了ACE。发生ACE的患者可能年龄较大、为男性、白人、居住在农村且合并症较多。入住ICU的患病率增加了126%（<0.01）。ACE的预测因素包括男性、年龄较大、冠状动脉疾病、心力衰竭、肾衰竭以及两种或更多种合并症。发生ACE的患者更有可能发生心脏骤停、血液透析、败血症和休克（均<0.01）。
需要ICU护理的重症SCD患者的患病率有所增加，随之而来的是发病率和死亡率上升。需要进一步研究以了解导致这些观察到的趋势和增加死亡率的潜在因素。
作者已确认本提交不需要临床试验注册。
