Hydroxyurea Therapy and Burn Wound Healing in Sickle Cell Disease: A TriNetX Database Study

Area of Science:

• Hematology
• Wound Healing Research
• Pharmacology

Background:

• Sickle cell disease (SCD) is a genetic blood disorder causing abnormal hemoglobin and complications like vaso-occlusive crises.
• Hydroxyurea effectively manages SCD but may impair skin wound healing, with unclear effects in burn patients.
• Burn injuries in SCD patients present unique challenges for wound management and recovery.

Purpose of the Study:

• To investigate the impact of hydroxyurea on mortality, wound infection, disruption, and sepsis in SCD patients with burn injuries.
• To compare wound healing outcomes and survival rates between SCD patients with burns who used hydroxyurea and those who did not.

Main Methods:

• Utilized the TriNetX database to identify adult SCD patients with prior burn injuries, stratifying by hydroxyurea use.
• Employed propensity score matching to control for demographic, comorbidity, and clinical variables (burn/SCD severity).
• Assessed mortality, wound infection, wound disruption, and sepsis at 30 days, 3 months, and 6 months post-burn using statistical analysis (chi-square, risk ratio).

Main Results:

• The hydroxyurea cohort exhibited a significantly higher risk of wound disruption, infection, and recurrent sepsis across all time points.
• Conversely, the hydroxyurea cohort demonstrated a significantly lower risk of mortality compared to the control group at all assessed time points.
• Statistical significance was set at p<.05.

Conclusions:

• Hydroxyurea use in SCD patients with burn injuries is associated with increased risks of wound healing complications.
• Despite wound healing challenges, hydroxyurea significantly reduces mortality risk in this patient population.
• Further research is crucial to understand hydroxyurea's wound healing mechanisms and explore alternative treatments for SCD patients with burns.