Acute Complications of Sickle Cell Disease in Children Under 5 Years at a Level II Hospital

Area of Science:

• Pediatrics
• Hematology
• Genetics

Background:

• Sickle Cell Disease (SCD) is a genetic blood disorder with significant health implications in early childhood.
• Acute complications requiring hospitalization are a major concern for children diagnosed with SCD.
• Understanding these complications is crucial for effective management and improved patient outcomes.

Purpose of the Study:

• To characterize the acute complications leading to hospitalization in children under five years old with Sickle Cell Disease.
• To identify the most frequent diagnoses and associated factors during hospital admissions for pediatric SCD patients.
• To quantify the burden of hospitalizations, including frequency, duration, and need for interventions like blood transfusions.

Main Methods:

• Retrospective analysis of hospitalization data for 70 pediatric patients (under 5 years) with Sickle Cell Disease.
• Inclusion criteria focused on patients with HbS homozygosity and African ancestry.
• Data analyzed included diagnoses, admission details, hemoglobin levels, and transfusion requirements.

Main Results:

• Vaso-occlusive crisis was the most common diagnosis (36.8%), followed by fever, upper airway infections, bacterial pneumonia, and splenic sequestration.
• The first hospitalization occurred before 12 months in 38.6% of patients, with an average of 3.92 admissions per child.
• 44.2% of patients required at least one blood transfusion, and splenic sequestration was linked to transfusion needs.

Conclusions:

• Acute complications, particularly vaso-occlusive crisis, represent a significant burden for young children with Sickle Cell Disease.
• Splenic sequestration is a notable early complication, often necessitating blood transfusions.
• Pediatric SCD patients experience substantial healthcare utilization, with an average of 3 weeks hospitalized per child annually.