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      Clinical-Epidemiological Characteristics and Mortality in Patients with Sickle Cell Anemia: A Retrospective Cohort Study of 1980 at 2018

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          Abstract

          Purpose

          To analyze the clinical-epidemiological characteristics and mortality in patients with sickle-cell anemia (SCA).

          Patients and Methods

          A cohort study with retrospective data, conducted in two reference hospitals for SCA treatment from January 1980 to December 2018, recorded in two reference services. With a 5% significance level, the Chi-Square and Student’s t-tests were employed in the inferential statistical analysis.

          Results

          A total of 128 patients with SCA were studied. Diagnosis up to the fifth day of life was made in 10 patients. There were 19 deaths, of which 12 (63.2%) were female, and the average age at death was 27.05 (± 14.78) years. The leading causes of death were septic shock and cardiogenic shock. The use of invasive medical devices was considered a risk factor for death (RR=2.63; 95% CI=1.16–5.96; p=0.018), and monitoring time up to 20 years presented a 31% reduction in the risk of dying (RR=0.31; 95% CI=0.12–0.82; p=0.011) when compared to the monitoring of more than 20 years.

          Conclusion

          These findings are to be considered in the treatment of patients with SCA, mainly regarding early diagnosis and access to the treatment immediately afterward, since they are fundamental in improving survival and reducing severe complications.

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          Most cited references62

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

          Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            Sickle-cell disease.

            Sickle-cell disease is one of the most common severe monogenic disorders in the world. Haemoglobin polymerisation, leading to erythrocyte rigidity and vaso-occlusion, is central to the pathophysiology of this disease, although the importance of chronic anaemia, haemolysis, and vasculopathy has been established. Clinical management is basic and few treatments have a robust evidence base. One of the main problems of sickle-cell disease in children is the development of cerebrovascular disease and cognitive impairment, and the role of blood transfusion and hydroxycarbamide for prevention of these complications is starting to be understood. Recurrent episodes of vaso-occlusion and inflammation result in progressive damage to most organs, including the brain, kidneys, lungs, bones, and cardiovascular system, which becomes apparent with increasing age. Most people with sickle-cell disease live in Africa, where little is known about this disease; however, we do know that the disorder follows a more severe clinical course in Africa than for the rest of the world and that infectious diseases have a role in causing this increased severity of sickle-cell disease. More work is needed to develop effective treatments that specifically target pathophysiological changes and clinical complications of sickle-cell disease. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Sickle Cell Disease

              New England Journal of Medicine, 376(16), 1561-1573
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                02 February 2022
                2022
                : 15
                : 1057-1074
                Affiliations
                [1 ]Integrated Institute of Health, Federal University of Mato Grosso do Sul , Campo Grande, Mato Grosso do Sul, Brazil
                [2 ]Graduate Program in Health and Development in the Midwest Region, Federal University of Mato Grosso do Sul , Campo Grande, Mato Grosso do Sul, Brazil
                Author notes
                Correspondence: Carolina Mariano Pompeo, Integrated Institute of Health, Federal University of Mato Grosso do Sul , Campo Grande, Mato Grosso do Sul, Brazil, Tel +55 67 99984-7048, Email carolmpompeo@gmail.com
                Author information
                http://orcid.org/0000-0003-4454-0140
                http://orcid.org/0000-0002-9123-232X
                http://orcid.org/0000-0002-9431-7484
                http://orcid.org/0000-0001-9323-599X
                http://orcid.org/0000-0003-3586-1313
                http://orcid.org/0000-0001-6094-3404
                http://orcid.org/0000-0002-2745-514X
                Article
                342971
                10.2147/IJGM.S342971
                8818769
                6c6522fc-8631-44d9-93c3-85e51dbd88ac
                © 2022 Pompeo et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 06 October 2021
                : 07 December 2021
                Page count
                Figures: 7, Tables: 12, References: 71, Pages: 18
                Funding
                Funded by: the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES);
                This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001, and by Federal University of Mato Grosso do Sul.
                Categories
                Original Research

                Medicine
                hematologic diseases,early diagnosis,neonatal screening,survival,epidemiology
                Medicine
                hematologic diseases, early diagnosis, neonatal screening, survival, epidemiology

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