Increased incidence of VTE in sickle cell disease patients: Risk factors, recurrence and impact on mortality

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2%) developed incident-VTE: 358 (51·6%) had PE (±DVT); 179 (25·7%) had lower-extremity DVT only and 158 (22·7%) had upper-extremity DVT. By 40 years of age, the cumulative incidence of VTE was 17·1% for severe SCD patients (hospitalized ≥3 times a year) versus 8·0% for the matched asthma controls. Amongst SCD patients, women (Hazard ratio [HR] = 1·22; 95% confidence interval [CI]: 1·05-1·43) and those with severe disease (HR = 2·86; 95% CI: 2·42-3·37) had an increased risk of VTE. Five-year recurrence was 36·8% in patients with severe SCD. VTE was associated with increased risk of death (HR = 2·88, 95% CI: 2·35-3·52). In this population-based study, the incidence of VTE was higher in SCD patients than matched controls and was associated with increased mortality. The high incidence of recurrent VTE in patients with severe SCD suggests that extended anticoagulation may be indicated.

Original languageEnglish (US)
JournalBritish Journal of Haematology
DOIs
StateAccepted/In press - 2017

Fingerprint

Sickle Cell Anemia
Recurrence
Mortality
Incidence
Venous Thrombosis
Confidence Intervals
Embolism
Upper Extremity Deep Vein Thrombosis
Lung
Venous Thromboembolism
Lower Extremity
Hospitalization
Asthma

Keywords

  • Deep vein thrombosis
  • Pulmonary embolism
  • Sickle cell disease
  • Thrombosis
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

@article{4d7b2e06151d4f0899cf831251673245,
title = "Increased incidence of VTE in sickle cell disease patients: Risk factors, recurrence and impact on mortality",
abstract = "Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2{\%}) developed incident-VTE: 358 (51·6{\%}) had PE (±DVT); 179 (25·7{\%}) had lower-extremity DVT only and 158 (22·7{\%}) had upper-extremity DVT. By 40 years of age, the cumulative incidence of VTE was 17·1{\%} for severe SCD patients (hospitalized ≥3 times a year) versus 8·0{\%} for the matched asthma controls. Amongst SCD patients, women (Hazard ratio [HR] = 1·22; 95{\%} confidence interval [CI]: 1·05-1·43) and those with severe disease (HR = 2·86; 95{\%} CI: 2·42-3·37) had an increased risk of VTE. Five-year recurrence was 36·8{\%} in patients with severe SCD. VTE was associated with increased risk of death (HR = 2·88, 95{\%} CI: 2·35-3·52). In this population-based study, the incidence of VTE was higher in SCD patients than matched controls and was associated with increased mortality. The high incidence of recurrent VTE in patients with severe SCD suggests that extended anticoagulation may be indicated.",
keywords = "Deep vein thrombosis, Pulmonary embolism, Sickle cell disease, Thrombosis, Venous thromboembolism",
author = "Ann Brunson and Amy Lei and Aaron Rosenberg and White, {Richard H} and Keegan, {Theresa H} and Theodore Wun",
year = "2017",
doi = "10.1111/bjh.14655",
language = "English (US)",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Increased incidence of VTE in sickle cell disease patients

T2 - Risk factors, recurrence and impact on mortality

AU - Brunson, Ann

AU - Lei, Amy

AU - Rosenberg, Aaron

AU - White, Richard H

AU - Keegan, Theresa H

AU - Wun, Theodore

PY - 2017

Y1 - 2017

N2 - Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2%) developed incident-VTE: 358 (51·6%) had PE (±DVT); 179 (25·7%) had lower-extremity DVT only and 158 (22·7%) had upper-extremity DVT. By 40 years of age, the cumulative incidence of VTE was 17·1% for severe SCD patients (hospitalized ≥3 times a year) versus 8·0% for the matched asthma controls. Amongst SCD patients, women (Hazard ratio [HR] = 1·22; 95% confidence interval [CI]: 1·05-1·43) and those with severe disease (HR = 2·86; 95% CI: 2·42-3·37) had an increased risk of VTE. Five-year recurrence was 36·8% in patients with severe SCD. VTE was associated with increased risk of death (HR = 2·88, 95% CI: 2·35-3·52). In this population-based study, the incidence of VTE was higher in SCD patients than matched controls and was associated with increased mortality. The high incidence of recurrent VTE in patients with severe SCD suggests that extended anticoagulation may be indicated.

AB - Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2%) developed incident-VTE: 358 (51·6%) had PE (±DVT); 179 (25·7%) had lower-extremity DVT only and 158 (22·7%) had upper-extremity DVT. By 40 years of age, the cumulative incidence of VTE was 17·1% for severe SCD patients (hospitalized ≥3 times a year) versus 8·0% for the matched asthma controls. Amongst SCD patients, women (Hazard ratio [HR] = 1·22; 95% confidence interval [CI]: 1·05-1·43) and those with severe disease (HR = 2·86; 95% CI: 2·42-3·37) had an increased risk of VTE. Five-year recurrence was 36·8% in patients with severe SCD. VTE was associated with increased risk of death (HR = 2·88, 95% CI: 2·35-3·52). In this population-based study, the incidence of VTE was higher in SCD patients than matched controls and was associated with increased mortality. The high incidence of recurrent VTE in patients with severe SCD suggests that extended anticoagulation may be indicated.

KW - Deep vein thrombosis

KW - Pulmonary embolism

KW - Sickle cell disease

KW - Thrombosis

KW - Venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=85017094304&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017094304&partnerID=8YFLogxK

U2 - 10.1111/bjh.14655

DO - 10.1111/bjh.14655

M3 - Article

C2 - 28369826

AN - SCOPUS:85017094304

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

ER -