Sickle cell disease patients hospitalized with CHF had significantly longer length of stay (6.5 vs 4.7 days, p<0.0001) and higher costs compared to those without CHF.
Observational (n=6,375)
Yes
What are the demographic characteristics, hospital utilization patterns, and predictors of in-hospital mortality among sickle cell disease patients with congestive heart failure?
Congestive heart failure in sickle cell disease patients is associated with significantly increased healthcare utilization, with acute respiratory failure and multimorbidity strongly predicting in-hospital mortality.
Absolute Event Rate: 6.5% vs 4.7%
p-value: p=<0.0001
Abstract Background Sickle cell disease (SCD) is a multisystem disorder characterized by chronic hemolysis, vaso-occlusion, and progressive end-organ damage. Cardiovascular complications, including congestive heart failure (CHF), have emerged as major contributors to morbidity and mortality in this population as life expectancy improves due to advances in disease-modifying therapies and supportive care. The pathophysiology of SCD-related CHF is multifactorial, involving chronic anemia, high-output cardiac states, and microvascular dysfunction. This study aims to evaluate demographic characteristics, hospital utilization patterns, and predictors of in-hospital mortality among SCD patients with CHF using a nationally representative cohort. Methods We performed a comprehensive retrospective analysis of the national inpatient sample (NIS) for sickle cell disease (SCD) patients with congestive heart failure (CHF) from January 2017 to December 2019. Appropriate ICD codes were utilized to extract SCD with chf patients. Chi-square analysis was used to evaluate comorbidities and students T test for continuous variables. A multivariate regression model was employed to determine predictors for in-patient mortality. Results There was a total of 6375 patients over a three-year period. SCD patients with CHF were older (56.4 vs 40.6, p = 0.0001), higher length of stay (LOS) (6.5 vs 4.7 days, p 0.0001), and increased costs (77875 vs 51100, p 0.0001). These patients had higher incidence of right sided coronary catherization (60 vs 45, p 0.0001) and mechanical circulatory device utilization (25 vs 5, p 0.0001). Acute respiratory failure (OR = 26.5, p 0.0001), Charleston comorbidity index (OR = 1.21, p 0.0001), alcoholism (OR = 2.02, p = 0.047) were found to be predictors of in-patient mortality. The mortality from SCD patients with SCD has been relatively stable over the last 3 years. Conclusion SCD patients hospitalized with CHF experience significantly greater healthcare utilization, morbidity, and mortality compared with those without CHF. Acute respiratory failure and multimorbidity strongly predict poor outcomes. These findings highlight the need for targeted preventive strategies and multidisciplinary management approaches to mitigate cardiovascular complications and improve survival in this high-risk population. This abstract is funded by: None
Yow et al. (2026) conducted an observational in Sickle cell disease with congestive heart failure (n=6,375). Congestive heart failure vs. No congestive heart failure was evaluated on Length of stay (days) (p=<0.0001). Sickle cell disease patients hospitalized with CHF had significantly longer length of stay (6.5 vs 4.7 days, p<0.0001) and higher costs compared to those without CHF.
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