Pulmonary Embolism in Sickle Cell Disease: A Case-Control Study

Details

• Alternative Title:
  J Thromb Haemost
• Personal Author:
  Novelli, Enrico M. ; Huynh, Cindy ; Gladwin, Mark T. ; Moore, Charity G. ; Ragni, Margaret V.
• Description:
  Introduction
  
  Pulmonary embolism (PE) is a leading cause of mortality in hospitalized patients, yet the prevalence of PE in sickle cell disease (SCD) and its relation to disease severity or intrinsic hypercoagulability are not established.
  
  Methods
  
  We estimated inpatient PE incidence and prevalence among SCD and non-SCD populations in Pennsylvania, and compared severity of illness and mortality, using Pennsylvania Health Care Cost Containment Council (PHC4) discharge data, 2001-2006. Risk factors for PE were assessed in a case-control study of discharges from the University of Pittsburgh Medical Archival Records System (MARS).
  
  Results
  
  The incidence of inpatient PE was higher in the SCD PA population than in the non-SCD Pennsylvania population, 2001-2006. The PE prevalence among SCD discharges ≤50 years of age, 0.57%, was similar to that in non-SCD Pennsylvania discharges, 0.60%, and unchanged after adjustment for race. Among SCD discharges, those developing PE were significantly older, with longer length ofstay, greater severity of illness, and higher mortality, p<0.001, than SCD without PE. Among PE discharges, SCD had similar severity of illness, p=0.77, and mortality, p=0.39, but underwent fewer computerized tomographic scans, p=0.006, than non-SCD with PE. In the local case-control study, no clinical or laboratory feature was associated with PE.
  
  Conclusions
  
  The incidence of PE is higher and chest CT utilization is lower in SCD than non-SCD inpatients, suggesting that PE may be under-diagnosed.
  
  
• Subjects:
  Adult Anemia, Sickle Cell Case-Control Studies Chi-Square Distribution Humans Incidence Middle Aged Patient Discharge Pennsylvania Predictive Value Of Tests Prevalence Pulmonary Embolism Risk Assessment Risk Factors Severity Of Illness Index Time Factors Tomography, X-Ray Computed Young Adult

  More +
• Keywords:
  Pulmonary Embolism Sickle Cell Disease Venous Thromboembolism
• Source:
  J Thromb Haemost. 10(5):760-766
• Pubmed ID:
  22417249
• Pubmed Central ID:
  PMC3343190
• Document Type:
  Journal Article
• Funding:
  UL1 TR000005/TR/NCATS NIH HHSUnited States/ ; UL1 RR024153/RR/NCRR NIH HHSUnited States/ ; U10DD000193/DD/NCBDD CDC HHSUnited States/ ; UL-1 RR024153/RR/NCRR NIH HHSUnited States/ ; U01 DD000193/DD/NCBDD CDC HHSUnited States/ ; 1-H-30-MC-0038-01/PHS HHSUnited States/ ; UL1 RR024153-01/RR/NCRR NIH HHSUnited States/
• Volume:
  10
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8421b9948beb1e5f54a05ab54226e83d149812c75cfe0ac6d31f8d75c269ba39
• Download URL:
  https://stacks.cdc.gov/view/cdc/33359/cdc_33359_DS1.pdf
• File Type:
  [PDF - 313.63 KB ]