Timing matters: An analysis of the relationship between red cell transfusion timing and hospitalization outcomes in sickle cell crisis patients using the National Inpatient Sample database

Authors

Zubair Hassan Bodla, University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA.
Mariam Hashmi, University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA.
Fatima Niaz, King Edward Medical University, Lahore, Punjab, Pakistan.
Umer Farooq, Rochester Regional HealthFollow
Farhan Khalid, Monmouth Medical Center, Long Branch, NJ, USA.
Abdullahi Hussein Abdullahi, University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA.
Sue-Wei Luu, Gainesville, Florida, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Annals of Hematology

Abstract

Vaso-occlusive pain crisis is a debilitating complication of sickle cell disease (SCD) and it is the most common cause of hospitalization among these individuals. We studied the inpatient outcomes among patients admitted with sickle cell crisis based on the timing of red blood cell transfusion. In this retrospective study, we used the United States National Inpatient Sample (NIS) data for the year 2019, to identify adult patients hospitalized with the principal diagnosis of sickle cell crisis who received simple red blood cell transfusion during their hospitalization. Patients were divided into two groups. Those who received simple red cell transfusion within 24 hours of admission were classified as early transfusion. After adjusting for confounders, the mean adjusted length of stay for patients with early transfusion was significantly lower than those who received a late blood transfusion by 3.51 days (p-value < 0.001) along with a decrease in mean adjusted hospitalization charges and cost, by 25,487 and 4,505 United States Dollar (USD) respectively. The early red cell transfusion was also associated with a decrease in inpatient mortality, demonstrated by an adjusted odds ratio (aOR) of 0.19 (p-value 0.036), and a reduction in in-hospital sepsis, with an aOR of 0.28 (p-value < 0.001), however, no statistically significant difference was found between the two groups regarding acute respiratory failure requiring intubation, vasopressors requirement, acute kidney injury requiring dialysis and intensive care unit (ICU) admission. We recommend timely triage and reassessment to identify sickle cell crisis patients requiring blood transfusion. This intervention can notably affect the inpatient length of stay, resource utilization, and hospitalization outcomes.

First Page

1669

Last Page

1676

DOI

10.1007/s00277-023-05275-6

Volume

102

Issue

7

Publication Date

7-1-2023

Medical Subject Headings

Adult; Humans; United States; Erythrocyte Transfusion; Inpatients; Retrospective Studies; Anemia, Sickle Cell; Hospitalization

PubMed ID

37249608

Recommended Citation

Bodla, Z. H., Hashmi, M., Niaz, F., Farooq, U., Khalid, F., Abdullahi, A. H., & Luu, S. (2023). Timing matters: An analysis of the relationship between red cell transfusion timing and hospitalization outcomes in sickle cell crisis patients using the National Inpatient Sample database. Annals of Hematology, 102 (7), 1669-1676. https://doi.org/10.1007/s00277-023-05275-6