VTE 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.