Google
Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Longitudinal Analysis of Patient Specific Predictors for Mortality in Sickle Cell Disease
source: PLOS ONE
year: 2016
authors: Curtis SA, Danda N, Etzion Z, Cohen HW, Billett HH
summary/abstract:INTRODUCTION:
White Blood Cell (WBC) count, %HbF, and serum creatinine (Cr), have been identified as markers for increased mortality in sickle cell anemia (SCA) but no studies have examined the significance of longitudinal rate of change in these or other biomarkers for SCA individuals.
METHODS:
Clinical, demographic and laboratory data from SCA patients seen in 2002 by our hospital system were obtained. Those who were still followed in 2012 (survival cohort) were compared to those who had died in the interim (mortality cohort). Patients lost to follow-up were excluded. Age adjusted multivariable Cox proportional hazards models were constructed to assess hazard ratios of mortality risk associated with the direction and degree of change for each variable.
RESULTS:
359 SCA patients were identified. Baseline higher levels of WBC, serum creatinine and hospital admissions were associated with increased mortality, as were alkaline phosphatase and aspartate aminotransaminase levels. Lower baseline levels of %HbF were also associated with increased mortality. When longitudinal rates of change for individuals were assessed, increases in Hb or WBC over patient baseline values were associated with greater mortality risk (HR 1.54, p = 0.02 and HR 1.16, p = 0.01 with negative predictive values of 87.8 and 94.4 respectively), while increasing ED use was associated with decreased mortality (HR 0.84, p = 0.01). We did not detect any increased mortality risk for longitudinal changes in annual clinic visits or admissions, creatinine or %HbF.
CONCLUSIONS:
Although initial steady state observations can help predict survival in SCA, the longitudinal course of a patient may give additional prognostic information.
DOI: 10.1371/journal.pone.0164743
read more full text
+myBinderRelated Content
-
Acute Care Utilization Is More Common in Patients with Sickle Cell Disease Who Have Chronic Complications and Chroni...Background: We undertook a large multisi...
-
Sickle cell disease and albuminuria: recent advances in our understanding of sickle cell nephropathyAlbuminuria is considered to be a releva...
-
Living With Sickle Cell Disease Is a Constant Battle With Pain, According to one Woman Who Has It“You don’t look sick.” That’s ...
-
Grant Recipient Uses Mobile Device Observation in Sickle Cell Pain StudyTechnology takes center stage in a new...
-
Fighting Through Our Pain TV With Thomas J. Harrington MDhttps://www.youtube.com/watch?time_conti...
-
More Online Queries in Winter Suggest Seasonal Variations in SCD ActivityMore people search for information on si...
-
Pregnant Women with Sickle Cell Disease, Especially SS-type, at Risk of ComplicationsWomen with sickle cell disease have a hi...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
Powered by
Support for this site is provided by
This platform is made possible through a partnership with the Sickle Cell Disease Association of America, Inc. (SCDAA) and its member organizations. SCDAA's mission is to advocate for people affected by sickle cell conditions and empower community-based organizations to maximize quality of life and raise public consciousness while advancing the search for a universal cure.