Hematological And Hemostasis Profile, Thrombotic Risk In Sickle Cell Patient In Cameroon : An Analytical Cross-Sectional Study

Abstract

Background : Thrombosis is a disease characterized by the formation of blood clots inside the vessels. It is a situation commonly encountered during certain pathologies in general and sickle cell disease in particular during which it is associated with a very high risk of ischemic stroke. The purpose of this study is to determine the profile of blood count and thrombotic risk in sickle cell patients. Methodology : We conducted an analytical cross-sectional study at the Bafoussam Regional Hospital over 03 months. The study population consisted of consecutively recruited homozygous sickle cell and sickle cell traits. Blood samples from the latter were collected and sent to the laboratory for the completion of the blood count and hemostasis profile. The results obtained were analyzed using statistical software R version 4.1.1. Univariate logistic regression analyses were used to identify factors associated with thrombotic risk in our study population. Results : The size of our population was 148 patients including 80 sickle cell patients and 68 with sickle cell trait AS. The frequency of thrombotic risk in the population was 35.1% with 52,5% in SS and 14.7%% in AS (p=0.002). The mean fibrinogen in SS and AS was 5.32±0.50 g/L and 4.63±0.00 g/L respectively (p<0.001). The mean Quick Time was 11.8±1.94 s for SS and 12.2±2.72 s for AS (p=0.336). The mean cephalin time and activator were 23.3±5.90 s for SS and 24.3±7.89 s for AS with and (p=0.395), respectively. The mean D-dimer in SS was 1.88±2.09 mg/L and 1.12±2.40 mg/L in AS (p=0.045). The mean hemoglobin in SS was 7.13±1.41 g/dL and in AS was 14.4±2.57 g/dL (p<0.001). Thrombocytosis is positively associated with thrombotic risk (Or = 2.52, 95% CI = [1.13; 5.63] ; (p=0.022)). Moreover, ‘AS’ status is beneficial for the occurrence of thrombotic risk unlike SS (Or = 0.16, 95% CI = [0.07; 0.35]; (p=0.001). In addition, elevated fibrinogen is a risk factor for thrombotic risk (OR=2.50, 95% CI = [4.99; 1.25]; p=0.009). Conclusion : Given the weight of sickle cell disease and its complex pathophysiology, knowledge, and understanding of thrombotic risk is imperative to guide therapeutic strategies in the management and clinical management of patients. These data highlight the need for regular and systematic hemostasis assessment in sickle cell patients to prevent possible risks of thrombosis.