Adult Sickle Cell Disease A Five-year Experience of Intensive Care Management in a University Hospital in Oman
Journal Title: Sultan Qaboos University Medical Journal - Year 2012, Vol 12, Issue 2
Abstract
Objectives: Sickle cell disease (SCD) is an inherited disease caused by an abnormal type of haemoglobin. It is one of the most common genetic blood disorders in the Gulf area, including Oman. It may be associated with complications requiring intensive care unit (ICU) admission. Tis study investigated the causes of ICU admission for SCD patients. Methods: Tis was a retrospective analysis of all adult patients ≥12 years old with SCD admitted to Sultan Qaboos University Hospital (SQUH) ICU between 1st January 2005 and 31st December 2009. Results: A total number of 49 sickle cell patients were admitted 56 times to ICU. Te reasons for admission were acute chest syndrome (69.6%), painful crises (16.1%), multi-organ failure (7.1%) and others (7.2%). Te mortality for SCD patients in our ICU was 16.1%. Te haemoglobin (Hb) and Hb S levels at time of ICU admission were studied as predictors of mortality and neither showed statistical signifcance by Student’s t-test. Te odds ratio, with 95% confdence intervals, was used to study other six organ supportive measures as predictors of mortality. Te need for inotropic support and mechanical ventilation was a good predictor of mortality. While the need for noninvasive ventilation, haemofltration, blood transfusions and exchange transfusions were not signifcant predictors of mortality. Conclusion: Acute chest syndrome is the main cause of ICU admission in SCD patient. Unlike other supportive measures, the use of inotropic support and/or mechanical ventilation is an indicator of high mortality rate SCD patient.
Authors and Affiliations
Qutaiba Amir Tawfc| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital Muscat, Oman, Rajini Kausalya| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital Muscat, Oman, Dhuha Al-Sajee| Departments of Pathology, Sultan Qaboos University Hospital Muscat, Oman, Jyoti Burad| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital Muscat, Oman, Ahmed K Mohammed| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital Muscat, Oman, Aravind Narayanan| Intensive Care Unit, Royal Adelaide Hospital, Australia
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