Prevalence, risk factors, and demographic insights of sickle cell hepatopathy in Omani adolescents and adults: A retrospective analysis

Background: Sickle cell hepatopathy (SCH) is a significant yet under-researched complication of sickle cell disease (SCD). Despite the substantial prevalence of SCD in Oman and the Gulf region, the burden and characteristics of SCH remain poorly defined. This study aimed to determine the prevalence of SCH and its associated demographic, clinical, and laboratory features among Omani adolescents and adults with SCD. Methods: We conducted a retrospective cross-sectional study at Sultan Qaboos University Hospital. Of 2,257 patients screened, 384 were diagnosed with SCH (prevalence 17%). After applying inclusion and exclusion criteria, 750 patients were analyzed: 384 SCH cases and 366 randomly selected controls without SCH. Demographic, clinical, and laboratory data were reviewed to identify associations. Results: SCH was significantly associated with cholelithiasis (56.6% vs. 38.5%, P = 0.0001) and exchange transfusions (36.6% vs. 20.8%, P = 0.0001). Patients with SCH were more likely to be male (51.1% vs. 37.8%, P = 0.0001) and younger (28.9 ± 8.7 vs. 31.0 ± 10.2 years, P = 0.002). Markers of hemolysis, including elevated lactate dehydrogenase (522.4 vs. 341.6 U/L, P < 0.0001) and higher reticulocyte counts (8.5% vs. 5.4%, P < 0.0001), were also associated with SCH. However, no independent predictors were identified in multivariate analysis. Conclusion: SCH affects nearly one in six Omani patients with SCD, with associations to younger age, male gender, cholelithiasis, and transfusion history. These findings highlight the importance of proactive screening and personalized management to improve outcomes in this high-risk population.