Sickle cell anemia morbidity in Northern Saudi Arabia

OBJECTIVE: Documentation of the morbidity in sickle cell patients presenting at the Northern Area Armed Forces Hospital, Hafr Al Batin, Kingdom of Saudi Arabia and the burden of delivering care to these patients.

METHODS: The record charts of all Saudi patients with Sickle Cell Anemia (SCA) admitted between June 1994 through to July 2001 were retrospectively analyzed. Focus was on age of patients, frequency of admissions, duration of hospital stay and requirements for blood transfusions.

RESULTS: The study embraced a total of 84 patients (53 males and 31 females) giving a male to female ratio of 1.7:1. The mean age of patients was 10.8 years while the mean age at first admission was 3.8 years. The frequency of admissions peaked at 754 admissions (51%) in the age group 8-15 years and 326 (22%) admissions in the age group 4-8 years. The most frequent causes for admissions were in order of frequency, pain crisis, hemolysis, infections and anemia. Maximum hospitalization occurred in the age group 12-18 years. In 415 occasions admission of patient lasted for only one day; in 470 instances for 2 days and in 166 patients for 3 days. These gave a total of 3945 patient days of which 1255 days (31.8%) were for 2 days or less.

CONCLUSION: Many of our patients were admitted for very short periods of stay in the ward for pain control, rehydration or blood transfusions. Costs can be reduced by managing them in a short stay ward. It would be helpful if a National Guideline for Management of Patients with SCA can be drawn up by a Committee of Clinical Hematologists and Clinicians with wide experience in management of patients with hemoglobinopathies. Such guidelines will aid Internists and Primary Health Care Physicians in smaller hospitals in the management of patients with SCA.