Prevalence and Outcomes of Sickle Cell Patients presenting to the Accident andEmergency Department of the Georgetown Public Hospital Corporation with Vaso-occlusive crisis from January 2020 to December 2022
Introduction
Vaso-occlusive crisis is one of the most common complications of Sickle cell
disease (SCD), resulting in Accident and Emergency (A&E) visits in both the pediatric and
adult populations. There are scarce studies on the prevalence of sickle cell disease and its
complications in Guyana.
Objectives
To evaluate the prevalence of SCD in both adults and children, the outcomes of
these patients presenting to the A&E department of the Georgetown Public Hospital
(GPHC): the associated rates of admission, the prevalence of treatment with Hydroxyurea or
Blood Transfusions, length of hospital stay, treat and release rates, discharge or deaths.
Method
This institutional observational analytic retrospective cross-sectional study of
SCD adults and children from January 2020 to December 2022 presenting to A&E of GPHC
used a total sampling of all SCD patients during the study period. A sample size of 211 was
statistically significant.
Results
A total of 1092 patients were included in the study. The prevalence of Vaso-
occlusive crisis was 364 per 100,000 patients for 2020-2022. The rate of Admission of
Patients with VOCs was 20%, 76% were treated and discharged and 4% absconded. Patients
on hydroxyurea had a lower rate of admission, of which 80% were discharged and 18% were
admitted. This was statistically significant with a 95% confidence interval and p-value of
0.006. The frequency of blood transfusions in 2020-2021 was 3.5%, with a 14% admission rate
after transfusion and a lower rate of discharge after transfusion.
Conclusion
Most cases of Vaso-occlusive crisis were seen in the year 2022. The majority of
cases are ‘treat and release’ with ‘joint pain’ referred to as the most common symptom. A
smaller percentage of patients admitted required blood transfusions and patients utilizing
hydroxyurea were less likely to be admitted or require blood transfusions.
Recommendations
A Knowledge, Attitudes, and Practice study may be conducted to
understand the gender disparity between Males and Females and the frequency of
Emergency visits and adherence to hydroxyurea.
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