Co-morbidities and mortality in patients with sickle cell disease in England: A 10-year cohort analysis using hospital episodes statistics (HES) data
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Author(s)
Type
Journal Article
Abstract
Patients with a primary diagnosis of sickle cell disease (SCD) with or without crisis during the 10-year period January 2009 to December 2018 were identified in the HES Admitted Patient Care (APC) dataset and matched with the Office for National Statistics (ONS) mortality dataset. Three sub-cohorts were defined: ‘crises’, ‘transfusions’ and ‘other SCD’. APC records were examined for co-morbidities commonly associated with SCD and 10-year mortality rates compared with the general population.
After data cleaning and exclusions, 9503 patients remained (entire cohort), with 1171, 201, and 8131 in crises, transfusions, and other SCD sub-cohorts, respectively. Median numbers of co-morbidities per patient were 2 (Interquartile range (IQR): 1–4), 2 (IQR: 1–3), and 1 (IQR: 0–2) in the crises, transfusions, and other SCD sub-cohorts, respectively. The majority of patients in the crises (63.2%) and transfusions (56.3%) cohorts had ≥2 co-morbidities, compared with 25.3% in the other SCD sub-cohort. Crude 10-year mortality rate was 5.3% (entire cohort), compared with 8.0% (crises) and 11.4% (transfusions) sub-cohorts; all rates were substantially higher than in age-sex matched general population.
Our study adds further evidence that morbidity and mortality associated with SCD in England is high.
After data cleaning and exclusions, 9503 patients remained (entire cohort), with 1171, 201, and 8131 in crises, transfusions, and other SCD sub-cohorts, respectively. Median numbers of co-morbidities per patient were 2 (Interquartile range (IQR): 1–4), 2 (IQR: 1–3), and 1 (IQR: 0–2) in the crises, transfusions, and other SCD sub-cohorts, respectively. The majority of patients in the crises (63.2%) and transfusions (56.3%) cohorts had ≥2 co-morbidities, compared with 25.3% in the other SCD sub-cohort. Crude 10-year mortality rate was 5.3% (entire cohort), compared with 8.0% (crises) and 11.4% (transfusions) sub-cohorts; all rates were substantially higher than in age-sex matched general population.
Our study adds further evidence that morbidity and mortality associated with SCD in England is high.
Date Issued
2021-07-01
Date Acceptance
2021-03-29
Citation
Blood Cells, Molecules, and Diseases, 2021, 89
ISSN
1079-9796
Publisher
Elsevier BV
Journal / Book Title
Blood Cells, Molecules, and Diseases
Volume
89
Copyright Statement
© 2021 Published by Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Publication Status
Published
Article Number
102567
Date Publish Online
2021-04-01