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Risk factors for venous thromboembolism in sickle cell disease

Neha Bhasin1, Li Zhang2, Ayotola Ajayi1

  • 1Department of Pediatrics, University of California San Francisco, Oakland, California, USA.

Research and Practice in Thrombosis and Haemostasis
|April 24, 2026
PubMed

Insights

Individuals with sickle cell disease (SCD) face a high risk of venous thromboembolism (VTE). Key risk factors include prior VTE or stroke, increased hospitalizations, smoking, central venous catheters, and hormonal therapy.

Area of Science:

  • Hematology
  • Vascular Medicine
  • Thrombosis Research

Background:

  • Sickle cell disease (SCD) significantly elevates the risk of venous thromboembolism (VTE).
  • Understanding VTE risk factors and recurrence is critical for managing SCD patients.

Purpose of the Study:

  • To identify risk factors associated with VTE development in individuals with SCD.
  • To determine the recurrence rate of VTE events in this patient population.

Main Methods:

  • Retrospective review of 719 patients with SCD from 2013-2023.
  • Comparison of patients who developed VTE versus those who did not.
  • Analysis of demographic and clinical data to identify risk factors.

Main Results:

  • 8.9% of SCD patients experienced VTE, with deep vein thrombosis (61%) and pulmonary embolism (28%) being most common.
  • Significant risk factors for VTE included prior VTE (OR 164), stroke (OR 39.8), and >=6 hospitalizations (OR 15.5).
  • Smoking (OR 7.2), central venous catheter use (OR 6.9), and hormonal therapy (OR 9.6) were also associated with increased VTE risk. The VTE recurrence rate was 31%.

Conclusions:

  • VTE risk in SCD is linked to a history of VTE or stroke, high healthcare utilization, central venous catheters, hormonal therapies, and smoking.
  • The high recurrence rate highlights the need for improved VTE prevention and treatment strategies in SCD patients.
Abstract

Keywords:
central venous catheterdeep vein thrombosispulmonary embolismsickle cell diseasevenous thromboembolism

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