Correlation Between Serum Lactate Dehydrogenase Levels and Pain Severity in Vaso-Occlusive Crises Among Sickle Cell...

Prognostic markers are pivotal in anticipating disease trajectories and tailoring prophylactic interventions for patients with sickle cell anemia (SCA). This study sought to elucidate the association between serum lactate dehydrogenase (LDH) levels and the severity of painful crises in individuals diagnosed with SCA. A cross-sectional, analytical study was conducted on 89 patients with confirmed SCA, presented to the Emergency Hematology Department of Baghaei 2 Hospital, Ahvaz, Iran, in 2018. All participants were diagnosed with painful vaso-occlusive crises (VOC) upon admission. After a comprehensive general and systemic examination, laboratory evaluations, including CBC, LDH, and CRP, were performed immediately after admission. Pain intensity was assessed by a trained nurse using the Visual Analog Scale (VAS) questionnaire. The gender distribution of the study cohort was balanced and statistically insignificant (P > 0.05). The mean age was 15.56 ± 2.86 years (range: 4-18 years), with a majority (83.15%) aged between 14 and 18 years. A robust and statistically significant positive correlation was observed between serum LDH levels and pain scores (P < 0.0001). Male patients exhibited significantly higher mean serum LDH levels than females (P = 0.049). Although a positive correlation was noted between LDH levels and hospitalization duration, this association was not statistically significant (P = 0.437). Six patients required ICU admission, and their mean LDH levels were substantially elevated compared to non-ICU patients (P < 0.001). Among ICU-admitted patients, one (12.1%) succumbed to complications; however, elevated LDH levels did not significantly predict mortality (P = 0.814). This study identifies a significant positive correlation between serum LDH levels and pain severity in SCA patients during painful crises. Elevated LDH levels were also linked to ICU admissions, particularly in male patients. While no significant association was found with hospitalization duration or mortality, LDH shows promise as a biomarker for disease severity, warranting further investigation.