Analysis of Causes of Hospitalization Among Children with Sickle Cell Disease in a Group of Private Hospitals in Jeddah, Saudi Arabia

Abstract

Purpose

Sickle cell anemia (SCA) is a chronic hematologic condition that requires frequent hospitalization representing a significant economic burden on the health services. The aim of this study was to explore the causes and underlying factors of hospitalization among children with SCA, as well as the factors affecting their length of hospital stay.

Patients and Methods

This retrospective study included children and adolescents less than 16 years old who were admitted in a group of private hospitals in Jeddah, Saudi Arabia, during the period from January 2018 to December 2019.

Results

A total of 94 patients were included in this study, 59.6% were males, with a mean age 7.29 ± 3.82 years. The majority of the patients (91.5%) had sickle cell disease. The most common cause of hospital admission was vaso-occlusive crises (VOC) (64.9%) followed by infection (24.5%), acute chest syndrome (ACS) (18.1%), and acute hemolytic crisis (12.8%). We found no significant difference between gender and different causes of admissions (p > 0.05). While in relation to age group, limb pain and back pain were found to be significantly more frequent among children ≥ 7 years old (p = 0.03,0.04), while infections were significantly more frequent among children < 7 years old (p = 0.003). We analyzed the length of hospital stay and different factors, and we found that the mean length of hospital stay was significantly higher among children who were admitted with infections (p = 0.01) and ACS (p < 0.001) and among children who are non-compliant on hydroxyurea (p = 0.04).

Conclusion

The most common cause of hospitalization among children with SCD in Jeddah, Saudi Arabia, was VOC followed by infection, ACS and acute anemia. The length of hospital stay was more prolonged among children with infection and ACS, as well as children who were non-compliant to hydroxyurea.

Keywords:

• vaso-occlusive crisis
• acute chest syndrome
• infection
• hydroxyurea

Acknowledgments

We would like to express our profound gratitude and deep regards to Professor Intessar Sultan, professor of internal medicine and the head of the research team at ISNC for her help and support in the statistical part of this research. Also, we would like to thank the staff members in the pediatric departments in Ibn Sina Hospital and Al Jedaani hospitals for their assistance during data collection.

Disclosure

The authors declare no conflicts of interest for this work.