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
Related Content
-
Altered Oxygenation, Vascular and Ischemic Pain Responses in Adults with Sickle Cell AnemiaThe clinical hallmark of sickle cell ane...
-
Today’s Faces of Sickle Cell Disease: Jennelle StephensonJennelle Stephenson was diagnosed with S...
-
Mental Health Resources for Black, Indigenous and People of Color (BIPOC)In addition to COVID-19, recent events h...
-
New Research Suggests SANGUINATE™ Reduces the Number of Sickled Red Blood Cells in Patients with Vaso-Occlusive Cr...SANGUINATE™, the only investigational ...
-
FertilityIf you might want to have children in th...
-
Safety and early hints of benefit seen in phase 1b trial of PF-04447943Sickle cell disease (SCD) patients were ...
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.