Risk factors for venous thromboembolism in sickle cell disease.

BACKGROUND

Individuals with sickle cell disease (SCD) have a high risk for venous thromboembolism (VTE).

OBJECTIVES

To determine the associated risk factors and recurrence rate of VTE in SCD.

METHODS

We performed a retrospective review of 719 individuals with SCD followed at our institution between 2013 and 2023 and compared those who developed VTE with those who did not.

RESULTS

Of the 719 patients reviewed, 64 (8.9%) patients had 71 VTEs during the study period; 28% of the VTE events were pulmonary embolism and 61% were deep vein thrombosis. The odds ratio (OR) for developing a VTE was 164 (P < .001) for patients with a history of VTE, and the VTE recurrence rate was 31% during the study period. In addition, a history of stroke (OR, 39.8; P < .001) and a record of 6 or more hospitalizations in a 12-month period (OR, 15.5; P < .001) were significant risk factors for VTE in SCD. Other risk factors included smoking (OR, 7.2; P < .001), presence of a central venous catheter (OR, 6.9; P < .001), and use of hormonal therapy (OR, 9.6; P < .001).

CONCLUSION

We conclude that the risk of VTE in SCD is associated with a history of VTE or stroke, increased health care utilization, use of CVCs, hormonal therapies, and smoking. The high VTE recurrence rate in this study suggests a need to better prevent and treat VTEs in individuals with SCD.