Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia
Mortadah Alsalman,1 Zaenb Alsalman,2 Hussain Abduljaleel Alkhalifa,3 Aman N Alfaraj,3 Ali Alkhalifah,4 Qasem Almulihi5 1Department of Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, King Faisal University...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-12-01
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| Series: | Journal of Blood Medicine |
| Subjects: | |
| Online Access: | https://www.dovepress.com/predictors-of-intensive-care-admission-among-adult-patients-with-sickl-peer-reviewed-fulltext-article-JBM |
| _version_ | 1797373565010444288 |
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| author | Alsalman M Alsalman Z Alkhalifa HA Alfaraj AN Alkhalifah A Almulihi Q |
| author_facet | Alsalman M Alsalman Z Alkhalifa HA Alfaraj AN Alkhalifah A Almulihi Q |
| author_sort | Alsalman M |
| collection | DOAJ |
| description | Mortadah Alsalman,1 Zaenb Alsalman,2 Hussain Abduljaleel Alkhalifa,3 Aman N Alfaraj,3 Ali Alkhalifah,4 Qasem Almulihi5 1Department of Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 3Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 4Emergency Department, Eastern Health Cluster, Dammam, Saudi Arabia; 5Emergency Department, King Fahad University Hospital, Al Khobar, Saudi ArabiaCorrespondence: Zaenb Alsalman, Departments of Family and Community Medicine, College of Medicine, King Faisal University, Po Box 3311, AlAhsa, 36346, Saudi Arabia, Tel +966545611633, Email Alsalman.zainab@hotmail.comPurpose: Sickle cell disease (SCD) comprises a complex group of hematologic disorders that are collectively the most common monogenic disorder and are associated with increased risk of intensive care unit admission (ICU). The purpose of this study is to investigate factors that predict admission of adult patients with SCD to the ICU.Patients and Methods: This was a cross-sectional study that enrolled adult patients with SCD from Saudi Arabia.Results: A total of 107 patients with SCD, with a median age 31.9± 12.1 years, were evaluated retrospectively. Regarding predictors of ICU admission, patients who indicated a history of blood transfusions were at 8.047-fold higher risk of ICU admission (OR=8.047; 95% CI=2.392– 27.07; p=0.001). Patients who started hydroxyurea were at least 3.071 times more likely to be admitted than those who did not (OR=3.071; 95% CI=1.164– 8.104; p=0.023). We also observed three or more hospitalizations per year to be associated with increased risk of ICU admission (OR=3.393; 95% CI=1.285– 8.960; p=0.014), with those making 3 to 5 visits annually having at least 10.4 times higher risk (OR=10.38; 95% CI=10.098– 98.19; p=0.041) and those with 6 to 10 ER admissions having 18 times higher risk (OR=18.00; 95% CI=2.149– 150.8; p=0.008). Finally, patients with high WBC were predicted to have at least 3.34 times higher risk of ICU admission (OR=3.337; 95% CI=1.131– 9.846; p=0.029).Conclusion: SCD is a multi-systemic disease associated with increased morbidity and mortality. Recognition of high-risk features in patients helps to eliminate subjectivity in ICU referral decision. Frequent hospitalization and emergency visits, multiple blood transfusions, and elevated white blood cell count were significantly associated with a higher rate of ICU admission despite hydroxyurea usage.Keywords: sickle cell disease, intensive care unit, hydroxyurea |
| first_indexed | 2024-03-08T18:51:18Z |
| format | Article |
| id | doaj.art-ba6bb7f2649640e0a592fd0cebaf72a4 |
| institution | Directory Open Access Journal |
| issn | 1179-2736 |
| language | English |
| last_indexed | 2024-03-08T18:51:18Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Blood Medicine |
| spelling | doaj.art-ba6bb7f2649640e0a592fd0cebaf72a42023-12-28T18:07:22ZengDove Medical PressJournal of Blood Medicine1179-27362023-12-01Volume 1467168089323Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi ArabiaAlsalman MAlsalman ZAlkhalifa HAAlfaraj ANAlkhalifah AAlmulihi QMortadah Alsalman,1 Zaenb Alsalman,2 Hussain Abduljaleel Alkhalifa,3 Aman N Alfaraj,3 Ali Alkhalifah,4 Qasem Almulihi5 1Department of Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 3Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 4Emergency Department, Eastern Health Cluster, Dammam, Saudi Arabia; 5Emergency Department, King Fahad University Hospital, Al Khobar, Saudi ArabiaCorrespondence: Zaenb Alsalman, Departments of Family and Community Medicine, College of Medicine, King Faisal University, Po Box 3311, AlAhsa, 36346, Saudi Arabia, Tel +966545611633, Email Alsalman.zainab@hotmail.comPurpose: Sickle cell disease (SCD) comprises a complex group of hematologic disorders that are collectively the most common monogenic disorder and are associated with increased risk of intensive care unit admission (ICU). The purpose of this study is to investigate factors that predict admission of adult patients with SCD to the ICU.Patients and Methods: This was a cross-sectional study that enrolled adult patients with SCD from Saudi Arabia.Results: A total of 107 patients with SCD, with a median age 31.9± 12.1 years, were evaluated retrospectively. Regarding predictors of ICU admission, patients who indicated a history of blood transfusions were at 8.047-fold higher risk of ICU admission (OR=8.047; 95% CI=2.392– 27.07; p=0.001). Patients who started hydroxyurea were at least 3.071 times more likely to be admitted than those who did not (OR=3.071; 95% CI=1.164– 8.104; p=0.023). We also observed three or more hospitalizations per year to be associated with increased risk of ICU admission (OR=3.393; 95% CI=1.285– 8.960; p=0.014), with those making 3 to 5 visits annually having at least 10.4 times higher risk (OR=10.38; 95% CI=10.098– 98.19; p=0.041) and those with 6 to 10 ER admissions having 18 times higher risk (OR=18.00; 95% CI=2.149– 150.8; p=0.008). Finally, patients with high WBC were predicted to have at least 3.34 times higher risk of ICU admission (OR=3.337; 95% CI=1.131– 9.846; p=0.029).Conclusion: SCD is a multi-systemic disease associated with increased morbidity and mortality. Recognition of high-risk features in patients helps to eliminate subjectivity in ICU referral decision. Frequent hospitalization and emergency visits, multiple blood transfusions, and elevated white blood cell count were significantly associated with a higher rate of ICU admission despite hydroxyurea usage.Keywords: sickle cell disease, intensive care unit, hydroxyureahttps://www.dovepress.com/predictors-of-intensive-care-admission-among-adult-patients-with-sickl-peer-reviewed-fulltext-article-JBMsickle cell diseaseintensive care unithydroxyurea |
| spellingShingle | Alsalman M Alsalman Z Alkhalifa HA Alfaraj AN Alkhalifah A Almulihi Q Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia Journal of Blood Medicine sickle cell disease intensive care unit hydroxyurea |
| title | Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia |
| title_full | Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia |
| title_fullStr | Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia |
| title_full_unstemmed | Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia |
| title_short | Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia |
| title_sort | predictors of intensive care admission among adult patients with sickle cell disease in eastern province of saudi arabia |
| topic | sickle cell disease intensive care unit hydroxyurea |
| url | https://www.dovepress.com/predictors-of-intensive-care-admission-among-adult-patients-with-sickl-peer-reviewed-fulltext-article-JBM |
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