Real-world Pharmacological Anticoagulation and Clinical Outcomes of Venous Thromboembolism in Adults with Sickle Cell Disease

<p>Sickle cell disease (SCD) is an inherited disease characterized by sickle-shaped red blood cells that can slow or block blood flow. It affects about 100,000 people in the United States, and occurs more commonly in people of African descent. SCD is considered as a hypercoagulable state and venous thromboembolism (VTE) is a serious disease-specific complication. However, there have been limited real-world studies on VTE in SCD patients. This work aims to provide a comprehensive assessment of the risk factors and treatment of VTE in adults with SCD by using longitudinal real-world data. First, a retrospective cohort study on 30-day readmission was conducted to give a general understanding of the treatment of SCD. It was found that SCD patients were at high risk of readmission, and younger adults had higher risk than older adults. The risk factors vary significantly by age. These findings suggest that multifaceted, age-specific interventions are needed to improve the clinical outcomes of SCD patients. Second, the treatment patterns of pharmacological anticoagulation in adults with SCD was studied by using a retrospective, repeated cross-sectional design. The results may contribute to the optimal selection of regimens or dosing and informed decision making on anticoagulant utilization in routine care. Third, the incidence of VTE and its associated risk factors and clinical outcomes were examined. Several SCD-related complications and treatments were found to be significantly associated with VTE. Landmark survival analysis demonstrated that early management of VTE may improve the overall survival of SCD patients.</p>

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Health Outcomes and Policy Research

Year dc:date.available

2024

Author dc:creator

• Chen, Ming

Contributors dc:contributor

• James Bailey, MD

• Longitudinal study
• Real-world evidence
• Risk factors
• Survival analysis
• Congenital, Hereditary, and Neonatal Diseases and Abnormalities
• Diseases
• Health and Medical Administration
• Hemic and Lymphatic Diseases
• Medicine and Health Sciences
• Quality Improvement

Repository record dc:identifier

https://dc.uthsc.edu/dissertations/689

OAI identifier oai:identifier

oai:dc.uthsc.edu:dissertations-1689