title: Clinical Factors Associated with Morbidity and Mortality in Patients Admitted with Sickle Cell Disease.
abstract: OBJECTIVE
  To determine the clinical factors associated with the length of hospitalization and mortality in patients with sickle cell disease (SCD).
  
  
  METHODS
  All patients with SCD admitted to the medical wards of the University Hospital of the West Indies, Jamaica, over a five-year period, January 1 to December 31, 2010, were reviewed. Data were extracted from hospital charts and comprised demographic and clinical information, investigations, interventions, duration of stay, pathological data and outcomes.
  
  
  RESULTS
  There were 105 patients reviewed; 84% were genotype Hb SS. Females accounted for 59% and males 41%. Overall mean age was 32.5 years (SD 13.7, range 12-66 years). The mean length of hospitalization was 10.2 days (SD 10.9, range 1-84 days). The main admission diagnoses were painful crisis, acute chest syndrome, severe anaemia, sepsis, hepatic sequestration, congestive cardiac failure and renal failure. The mean value for the following laboratory investigations were: haemoglobin 7.7 g/dL (SD 2.8), total white blood cell count 21.7 x 109/L (SD 14.2), platelet count 320 x 109/L (SD 191.9), blood urea 9.8 mmol/L (SD 11.9) and serum creatinine 198 umol/L (SD 267.9). Medical interventions included: blood transfusions in 20.9%, 55% received antibiotics and 74% received narcotic analgesia. There were 40 deaths with four autopsies done. The mortality rate for SCD was 38%. There were 189 repeat SCD admissions.
  
  
  CONCLUSIONS
  Sickle cell disease still carries a high morbidity and mortality in patients admitted to hospital. Recurrent admissions are a concern, as they impact on patient's morbidity and quality of life.
authors: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors: K
authors: K
authors: Galloway-Blake
authors: Tropical Medicine Research Institute (Sickle Cell Unit), The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors: M
authors: M
authors: Reid
authors: Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors: C
authors: C
authors: Walters
authors: Department of Pathology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors: J
authors: J
authors: Jaggon
authors: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies. michael.lee@uwimona.edu.jm.
authors: M G
authors: MG
authors: Lee