Outcome of overt stroke in sickle cell anaemia, a single institution's experience

Suvankar Majumdar, Morgan Miller, Majid Khan, Catherine Gordon, Amy Forsythe, Mary G. Smith, Gail Megason, Rathi Iyer

Research output: Contribution to journalArticle

Abstract

Stroke is a traumatic complication in sickle cell anaemia (SCA) that is associated with significant morbidity and a risk of recurrent overt stroke of 2·2-6·4 events per 100 patient-years. A retrospective study was performed on all paediatric SCA patients diagnosed with a history of overt stroke between 1997 and 2010. A total of 31 children with SCA had new onset overt stroke. The mean age of the active patients (n = 27) was 17·9 years (range 6·8-27·6 years) with a total period of observation of 305 patient-years. Twenty-two of 27 (81%) were receiving long term red blood cell transfusions and 16 (59%) were taking the anti-platelet agent, aspirin, since diagnosis of the stroke. Two of 27 (7%) patients had a second overt stroke with an overall risk of recurrent stroke of 0·66/100 patient-years (one stroke was ischaemic and the other haemorrhagic). In patients taking aspirin with 180 patient-years of follow up, the recurrence rate of haemorrhagic stroke was 0·58/100 patient-years. We have an excellent outcome for overt stroke in paediatric SCA patients with a low rate of recurrent stroke. Further studies are needed to determine the risk-benefit ratio of aspirin therapy in the prevention of recurrent stroke in paediatric SCA.

Original languageEnglish (US)
Pages (from-to)707-713
Number of pages7
JournalBritish journal of haematology
Volume165
Issue number5
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • Aspirin
  • Platelet
  • Sickle cell anaemia
  • Stroke
  • Survival

ASJC Scopus subject areas

  • Hematology

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    Majumdar, S., Miller, M., Khan, M., Gordon, C., Forsythe, A., Smith, M. G., Megason, G., & Iyer, R. (2014). Outcome of overt stroke in sickle cell anaemia, a single institution's experience. British journal of haematology, 165(5), 707-713. https://doi.org/10.1111/bjh.12795