PB1335 - Prevalence of venous thromboembolism and its associations with demographics, disease spectrum and hydroxyurea use in a large racially homogenous population of sickle cell disease patients in Nigeria

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

HO

Helen Chioma Okoye, FMCPath, FWACP

Consultant
Department of Haematology and Immunology, College of Medicine, University of Nigeria Ituku Ozalla Campus Enugu, Nigeria
Enugu, Enugu, Nigeria

Co-Author(s)

CE

Chinedu Ezekekwu

Lecturer
College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu
enugu, Enugu, Nigeria
Theresa U. Nwagha, MPH,FMCPatg

Consultant Haematologist
University of Nigeria , College of Medicine Ituku Ozalla Campus
Enugu, Enugu, Nigeria
KK

Kaladada Korubo

Professor
University of Port Harcourt Teaching Hospital
Port Harcourt, Rivers, Nigeria
HO

Hannah Omunakwe

Associate Professor
Department of Haematology, Rivers State University Teaching Hospital Rivers state
Port Harcourt, Rivers, Nigeria
ON

Oluomachi Nnachi

Consultant
Department of Haematology and Blood Transfusion, Alex Ekwueme Federal University Teaching Hospital, Abakaliki
Abakaliki, Ebonyi, Nigeria
AM

Anazoeze Madu

Associate Professor
College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu
enugu, Enugu, Nigeria
BN

Benedict Nwogoh

Senior Lecturer
University of Benin
Benin, Edo, Nigeria
CE

Chilota Efobi

Senior Lecturer
Department of Haematology and Blood Transfusion, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus Anambra state
Awka, Anambra, Nigeria
EM

Ebele Muoghalu

Consultant
UNTH
enugu, Enugu, Nigeria
CN

Charles Nonyelu

Lecturer
College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu
Enugu, Ekiti, Nigeria
AO

Augustine Okoye

Lecturer
Alex Ekwueme Federal University Teachinh Hospital Abakaliki
Abakaliki, Ebonyi, Nigeria
OO

Onochie Obodo

HTC comprehensive care team
University of Nigeria Teaching Hospital
Enugu, Enugu, Nigeria
CU

Chioma Ugwu

SR
UNTH
enugu, Enugu, Nigeria
ME

Michael Egolum

REGISTRAR
UNTH
ENUGU, Enugu, Nigeria
on

oji nnachi

SR
Alex Ekwueme Federal University Teachinh Hospital Abakaliki
Abakaliki, Ebonyi, Nigeria
IO

Iheanyi Okpala

Professor
College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu
enugu, Enugu, Nigeria

Background: Sickle cell disease (SCD) is associated with altered haemostatic balance. There are reports of high prevalence of venous thromboembolism (VTE) in SCD.There are no previous studies reporting the prevalence of VTE in SCD in Nigeria, a country which bears the greatest burden of SCD. We hypothesize that there is no significant association between patient demographics, disease phenotype, clinical spectrum, organ damage and use of hydroxyurea and VTE.

Aims: To determine the prevalence of VTE in SCD in Nigeria and its associations.

Methods: This is a multicentre retrospective study where case notes of adult (age ≥18 years) SCD patients receiving care at the centres were reviewed. Information on demographics, steady state hemogram parameters, clinical phenotypes, duration of follow-up, history of VTE including risk factors and management were collected.

Results: Out of the 509 SCD patients with a median (IQR) duration of follow-up of 2 (1-5) years., 10 (2.0%) had VTE (9 DVT and PE). Their median (IQR) age was 27 (22.8-30.3) years, out of which 4 were below 25 years, 5 were between 25 and 39 years and only 1 was ≥40 years. Identifiable risk factors for VTE include positive family history (2, 20%) surgery, splenectomy, paraplegia, and cancer associated thrombosis (1, 10% each). No identifiable risk in 4. There was no significant association between VTE and age, gender and haemoglobin phenotype. VTE was significantly associated with viscosity/vaso-occlusive phenotype {vaso-occlusive crisis – p-value 0.035; acute chest syndrome – p-value 0.002, odd ratio 8 95%CI 2.2-28.9; osteonecrosis- p-value 0.012 OR 5.24 95%CI1.45-18.91 Pulmonary hypertension and stroke also showed significant association with VTE – p-value 0.001 OR 23.3 95%CI 5.18-105.06 and p-value 0.032 OR 9.35 95%CI 0.87-53.25. Hydroxyurea use had no significant association with VTE.

Conclusion(s): prevalence of VTE in Nigeria is low and it is significantly associated with viscosity/vaso-occlusive phenotype. pulmonary hypertension and stroke.