Ten-year review of hospital admissions among children with sickle cell disease in Kuwait

Abstract

Objective: This study was designed to document the common causes and patterns of hospitalization among sickle cell disease (SCD) patients in Kuwait.

Subjects and methods: The case files of all SCD patients admitted to the hospital between 1995 and 2004 were studied. Their personal data, hemoglobin genotype, diagnosis on admission, complete blood count, treatment received, length of stay and outcome were documented.

Results: Fifty SCD patients aged from 10 months to 14.8 years (mean: 8.7 +/- 2.8 years) had 351 admissions over the 10-year period accounting for 0.6% of all admissions to the pediatric wards. The 50 patients were made up of 18 Hb SS, 28 S beta(0)thal and 4 Hb SD patients. Common causes of admission were vaso-occlusive crisis: 222 (63.2%), acute splenic sequestration crisis: 32 (9.1%), hemolytic crisis: 31 (8.8%) and acute chest syndrome: 23 (6.6%). Stroke was seen in only 1 patient, and bacteriologically proven (Salmonella) acute osteomyelitis in 1 patient. There were no deaths during the study period.

Conclusions: Vaso-occlusive crisis was the commonest cause of hospitalization among our SCD patients. Efforts should be intensified to give advice on preventive measures. The use of hydroxyurea should be encouraged in patients with frequent severe pain crises.