Hemoglobin Levels and Social Determinants of Health as Risk-factors of End-Organ Damage in Sickle Cell Disease: A Retrospective Analysis
Author(s)
Helen Hale, MBA1, Abhishek Gaur, MBA1, Abhishek Singh, M.Tech (Pharma Eng.)1, Shrey Saklani, PGDM1, John O'Connor, BS2, Ben Phillips, PhD3, Aditya Jindal, MBA4.
1Syneos Health, Morrisville, NC, USA, 2Syneos Health, New York, NY, USA, 3Syneos Health Consulting, London, United Kingdom, 4Syneos Health Consulting, Gurugram, India.
1Syneos Health, Morrisville, NC, USA, 2Syneos Health, New York, NY, USA, 3Syneos Health Consulting, London, United Kingdom, 4Syneos Health Consulting, Gurugram, India.
Presentation Documents
OBJECTIVES: Sickle cell disease (SCD) is a complicated blood condition that affects multiple organs. The American Society of Hematology places a high priority on treatment of end-organ damage (EOD) in SCD individuals. There are currently no predictors for determining who is at danger of end-organ damage due to disease progression. The objective of this study is to determine how hemoglobin (Hb) levels and Social Determinants of Health (SDoH) factors relate to end-organ damage (EOD) in patients with sickle cell disease (SCD).
METHODS: We conducted a retrospective analysis of electronic health records (EHR) spanning January 2018 to December 2024. Patients with sickle cell anemia were identified using ICD diagnosis codes. Individuals with recorded initial Hb levels were included in the study. Patients were followed-up post-diagnosis to estimate the onset of new EOD, including chronic kidney disease, pulmonary hypertension, stroke, and leg ulcers. The CDC-derived Social Vulnerability Index (SVI) served as a proxy for determining patients' SDoH. Multivariable generalized estimating equations will be applied to estimate the association between Hb levels, SVI, and EOD risk.
RESULTS: Out of 7,362 SCD patients, 1,997 had available Hb levels. EOD was observed in 15.4% of patients. Notably, for every 1 g/dL increase in Hb, the risk of EOD decreased. EOD observed in 52% of patients with Hb levels <6 g/dL and 10% of patients with Hb levels >=13 g/dL.
CONCLUSIONS: Higher Hb levels are associated with a reduced risk of developing EOD in SCD patients. The influence of social determinants through SVI on these outcomes will be the subject of further exploration.
METHODS: We conducted a retrospective analysis of electronic health records (EHR) spanning January 2018 to December 2024. Patients with sickle cell anemia were identified using ICD diagnosis codes. Individuals with recorded initial Hb levels were included in the study. Patients were followed-up post-diagnosis to estimate the onset of new EOD, including chronic kidney disease, pulmonary hypertension, stroke, and leg ulcers. The CDC-derived Social Vulnerability Index (SVI) served as a proxy for determining patients' SDoH. Multivariable generalized estimating equations will be applied to estimate the association between Hb levels, SVI, and EOD risk.
RESULTS: Out of 7,362 SCD patients, 1,997 had available Hb levels. EOD was observed in 15.4% of patients. Notably, for every 1 g/dL increase in Hb, the risk of EOD decreased. EOD observed in 52% of patients with Hb levels <6 g/dL and 10% of patients with Hb levels >=13 g/dL.
CONCLUSIONS: Higher Hb levels are associated with a reduced risk of developing EOD in SCD patients. The influence of social determinants through SVI on these outcomes will be the subject of further exploration.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD1
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)