Study of vaso-occlusive (pain) crises in patients of sickle cell disease (SCD) – one year TMH experience

Background: Sickle cell disease (SCD) is a chronic, potentially life-threatening, inherited hemoglobinopathy of which pain is (the) hallmark. Amongst the various complications of SCD, painful vaso-occlusive crisis (VOC) is the most frequent cause of hospitalization, impaired health-related quality of life with increased mortality. The painful crisis, manifests as pain in the extremities, back, abdomen, or chest. As sickle cell disease is prevalent in and around Jamshedpur with affection of both tribal and non-tribal groups and an important cause of mortality and morbidity, one year study was undertaken with the Aim: To describe the clinical spectrum, laboratory parameters, efficacy of treatment and outcome in adults with pain crisis of sickle cell anemia admitted in Tata Main Hospital (TMH) over one year. Methods and Materials: This was a retrospective cohort study done from 1st March 2015 to 28th February 2016 and included patients admitted in the medical wards, of TMH, Jamshedpur. Results: A total of 32 patients were admitted with 50 pain episodes. The average pain rate was 0.492 patient-years. The average pain score was 8.9 ± 1.1 for males and for females was 8.6 ± 1.24. Most patients, 46.9% were in the age group of 21 to 30 years while only 2 patients (6.2%) were beyond the fourth decade of life. 25% of the patients had recurrent episodes. Sites of pain involvement were varied with involvement of knee being most common (78%). Length of stay (LOS) was maximum (7.12 ± 3.9) in patients with severe pain score. There was no mortality during the study period. Conclusion: VOC represents a chaotic interval in the life of patients of SCD which needs immediate and appropriate treatment with counseling to avoid complications.