Liver Cirrhosis and In-Hospital Outcomes in Patients With Sickle Cell Crises

Area of Science:

• Hematology
• Hepatology
• Critical Care Medicine

Background:

• Sickle cell disease (SCD) is a complex hematologic disorder with vaso-occlusive crises and end-organ damage.
• Sickle cell hepatopathy, including cirrhosis, can complicate SCD management and impact liver function.
• The effect of cirrhosis on in-hospital outcomes for SCD patients is not well-defined.

Purpose of the Study:

• To investigate the association between cirrhosis and in-hospital outcomes in adults hospitalized with sickle cell crises.
• To analyze the impact of cirrhosis on mortality, mechanical ventilation, and vasopressor use in SCD patients.

Main Methods:

• Retrospective cohort study utilizing the 2021 National Inpatient Sample (NIS).
• Inclusion of adult patients (≥18 years) hospitalized with sickle cell crises, stratified by cirrhosis status.
• Logistic regression analysis adjusted for confounders, with survey weights for national representativeness.

Main Results:

• Cirrhotic SCD patients were older and had more comorbidities.
• In-hospital mortality was significantly higher in cirrhotic patients (2.86% vs. 0.27%; aOR 3.79).
• Mechanical ventilation was more frequent in cirrhotic patients (3.39% vs. 0.27%; aOR 5.46).

Conclusions:

• Cirrhosis is associated with significantly worse in-hospital outcomes for patients hospitalized with sickle cell crises.
• Enhanced clinical monitoring and tailored management strategies are crucial for cirrhotic SCD patients.
• Further research is needed to develop interventions mitigating hepatic complications in SCD.