Prevalence of venous thromboembolism and its associations in a large racially homogenous population of sickle cell disease patients

• Published in: European journal of haematology Vol. 109; no. 4; pp. 321 - 326
• Main Authors: Okoye, Helen Chioma, Ezekekwu, Chinedu, Nwagha, Theresa Ukamaka, Korubo, Kaladada, Omunakwe, Hannah E., Nnachi, Oluomachi Charity, Madu, Anazoeze Jude, Nwogoh, Benedict, Efobi, Chilota Chibuife, Muoghalu, Ebele Adaobi, Nonyelu, Charles, Okoye, Augustine E., Obodo, Onochie Ikenna, Ugwu, Chioma Sandra, Egolum, Michael C., Nnachi, Oji Anya, Okpala, Iheanyi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-10-2022
• Subjects: Hypertension; Medical records; Osteonecrosis; Paraplegia; Patients; Phenotypes; Pulmonary hypertension; Risk factors; Sickle cell disease; Splenectomy; Thromboembolism; Nigeria; Prevalence; Nigeria; Sickle cell disease; Venous thromboembolism
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/ejh.13811

To determine the prevalence of venous thromboembolism (VTE) among adult sickle cell disease (SCD) patients in Nigeria.
Methods
This was a multicentre retrospective study in which the medical records of adult SCD patients were reviewed. Information on demographics, steady‐state haemogram, clinical phenotypes, duration of follow‐up, history of VTE including risk factors and management was collected.
Results
Of the 509 SCD patients with a median (IQR) duration of follow‐up of 2 years, 10 (2.0%) had VTE (9 DVT and 1 PE). Their median (IQR) age was 27 (22.8–30.3) years. Identifiable risk factors for VTE included positive family history (2, 20%) surgery, splenectomy, paraplegia and cancer (1, 10% each). No risk factor was identifiable in four persons. VTE had no significant association with age and gender. VTE was significantly associated with the following events: acute chest syndrome [p = .002, odds ratio (OR) 8, 95% CI 2.2–28.9], osteonecrosis [p = .012, OR 5.24, 95% CI, 1.45–18.91] and vaso‐occlusive crisis [p = .035]. Also significantly associated with VTE were pulmonary hypertension [p = .001, OR 23.3, 95%CI 5.18–105.06] and stroke [p = .032, OR 9.35, 95%CI 0.87–53.25].
Conclusion
The prevalence of VTE among SCD patients in Nigeria is low. It is significantly associated with vaso‐occlusive crisis, pulmonary hypertension and stroke.