Trends, Predictors, and Outcomes of Critically Ill Patients With Sickle Cell Disease in the United States

Despite recent advances in sickle cell disease (SCD) research and management, there remains very limited information available on critically ill SCD patients requiring intensive care units (ICUs).

The National Inpatient Sample was queried using the International Classification of Diseases codes to identify critically ill patients with SCD requiring ICU admission. These patients were further stratified into those with and without adverse clinical events (ACEs). The study outcomes were the incidence of acute chest syndrome, cardiac arrest, hemodialysis, sepsis, shock, and transfusion.

Of 5941 patients admitted to the ICU, 2826 (47.6%) had ACE. Patients with ACE were likely to be older, male, white, rural, and have higher comorbidities. The prevalence of ICU admission increased by 126% (p < 0.01). The predictors of ACE included male sex, older age, coronary artery disease, heart failure, renal failure, and two or more comorbidities. Patients with ACE were more likely to have cardiac arrest, hemodialysis, sepsis, and shock (all p < 0.01).

There has been an increase in the prevalence of critically ill SCD patients requiring ICU care, with subsequent morbidity and mortality. Further research is needed to understand the underlying factors that drive these observed trends and increase mortality rates.

The authors have confirmed clinical trial registration is not needed for this submission.