Patterns of Blood Transfusion in Sickle Cell Disease Hospitalizations

Author:

Sharma Aditi1,Dahiya Amit2,Alavi Asif3,Woldie Indryas1,Sharma Aditya4,Karson Jeffrey5,Singh Vijendra1

Affiliation:

1. Department of Hematology/Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA

2. Department of Medicine, Wayne State University, Detroit, MI 48202, USA

3. Department of Hematology/Oncology, Henry Ford Cancer Institute, Detroit, MI 48202, USA

4. Department of Medicine, Sardar Patel Medical College, Bikaner 334001, India

5. Department of Medicine, Detroit Medical Center Huron Valley-Sinai Hospital, Detroit, MI 48382, USA

Abstract

Background: Transfusional iron overload causes significant morbidity and mortality in sickle cell disease (SCD). Nevertheless, red blood cell transfusions continue to be essential in its management. This study describes the transfusion patterns among SCD hospitalizations. Methods: Hospitalizations for SCD in the 2017–2018 Nationwide Readmissions Database were divided into two groups based on whether they received transfusions. Descriptive analysis was performed to compare their demographics and complications. Multivariable logistic regression was performed to determine the factors associated with transfusions. Results: Out of 109,783 hospitalizations, 28,300 were transfused, and 81,483 were not transfused. Females and older individuals were higher in the transfused category than the non-transfused category (59.49% vs. 53.52% and 28.86% vs. 21.27%, respectively; p < 0.001 for both). The wealthiest population was more likely to be in the transfused category (11.27% vs. 8.34%; p < 0.001). Admissions to teaching hospitals, large metropolitan hospitals, and highest-volume hospitals were higher in the non-transfused category vs. transfused category (79.89% vs. 72.17%; p < 0.001, 69.26% vs. 65.35%; p 0.003 and 74.71% vs. 63.51%; p < 0.001, respectively). Most admissions were transfused once, with three or more transfusions being given more in the non-teaching hospitals than the teaching hospitals (1.27% vs. 0.41%; p 0.01). Furthermore, a higher proportion of early transfusions occurred in the non-teaching hospitals (65.6% vs. 57.82% for admission days 1 and 2; p < 0.001). Admission to a teaching hospital was associated with lower blood transfusion odds than a non-teaching hospital. Conclusion: A quarter of admissions for SCD receive a blood transfusion. In addition to performing more frequent and early transfusions, the odds of being transfused are higher in non-teaching hospitals.

Publisher

MDPI AG

Subject

General Earth and Planetary Sciences,General Environmental Science

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