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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Circumstances of death in adult sickle cell disease patients
American Journal of Hematology, Volume 81, No. 11, Year 2006
Notification
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Description
The purpose of the study was to analyze clinical and/or autopsy findings at the time of death among adults with sickle cell disease (SCD) at Howard University in Washington, DC over a 25-year period. A single physician recorded circumstances of death among 141 adult SCD patients he treated and knew well from 1976 to 2001. These findings were determined by autopsy report and/or clinical assessment. In a subset of 31 patients, autopsy records were reviewed for reports of iron deposition in liver and heart and of organ pathology. One hundred and fourteen (80.9%) of the patients had SS phenotype and 66 (46.8%) were female. The mean ± SD age at death was 36 ± 11 years. Leading circumstances of death included pulmonary hypertension (PHT) (26.2%), sudden death (23.4%), renal failure (22.6%), infection (18.4%), thromboembolism (14.9%), cardiac diagnoses (12.0%), cirrhosis (11.3%), pneumonia or acute chest syndrome (9.9%), bleeding (7.8%), and iron overload (7.0%). When circumstances of deaths that occurred after 1991 (n = 69) were compared to those that occurred in 1991 or earlier (n = 72), PHT (36.2% vs. 16.6%; P < 0.01) was significantly more common in 1992 or later. Significant associations were found between PHT and thromboembolism and between cirrhosis and iron overload. In this proportional mortality study of adults with SCD, PHT was the leading finding at the time of death. Thromboembolism was associated with PHT, and iron overload was associated with cirrhosis. © 2006 Wiley-Liss, Inc.
Authors & Co-Authors
Darbari, Deepika S.
United States, Washington, D.c.
The Center for Sickle Cell Disease
United States, Washington, D.c.
Howard University
United States, Washington, D.c.
Childrens National Health System
Kple-Faget, Paul
Cote D'ivoire, Bouake
University of Bouake
Kwagyan, John
United States, Washington, D.c.
Howard University
Rana, Sohail R.
United States, Washington, D.c.
Howard University
Gordeuk, Victor R.
United States, Washington, D.c.
The Center for Sickle Cell Disease
Castro, Oswaldo Ido
United States, Washington, D.c.
The Center for Sickle Cell Disease
Statistics
Citations: 261
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1002/ajh.20685
ISSN:
03618609
e-ISSN:
10968652
Research Areas
Noncommunicable Diseases
Participants Gender
Female