Survival Probability in Patients with Sickle Cell Anemia Using the Competitive Risk Statistical Model.

Abstract:

:The clinical picture of patients with sickle cell anemia (SCA) is associated with several complications some of which could be fatal. The objective of this study is to analyze the causes of death and the effect of sex and age on survival of Brazilian patients with SCA. Data of patients with SCA who were seen and followed at HEMORIO for 15 years were retrospectively collected and analyzed. Statistical modeling was performed using survival analysis in the presence of competing risks estimating the covariate effects on a sub-distribution hazard function. Eight models were implemented, one for each cause of death. The cause-specific cumulative incidence function was also estimated. Males were most vulnerable for death from chronic organ damage (p = 0.0005) while females were most vulnerable for infection (p=0.03). Age was significantly associated (p ≤ 0.05) with death due to acute chest syndrome (ACS), infection, and death during crisis. The lower survival was related to death from infection, followed by death due to ACS. The independent variables age and sex were significantly associated with ACS, infection, chronic organ damage and death during crisis. These data could help Brazilian authorities strengthen public policies to protect this vulnerable population.

authors

do Nascimento EM,de Castro Lobo CL,de Bragança Pereira B,Ballas SK

doi

10.4084/MJHID.2019.022

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

e2019022

issue

1

issn

2035-3006

pii

mjhid-11-1-e2019022

journal_volume

11

pub_type

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