65 - Incidence of Venous Thromboembolism among Youth with Sickle Cell Disease

Publication Number: 3062.65

Krista Latta, University of Michigan Medical School, Ann Arbor, MI, United States; Lauren Merz, University of Michigan Medical School, Ann Arbor, MI, United States; Melissa Plegue, University of Michigan Medical School, Ann Arbor, MI, United States; Angela C. Weyand, University of Michigan Medical School, Ann Arbor, MI, United States; Sharon Singh, University of Michigan Medical School, Ann Arbor, MI, United States; Sarah L. Reeves, University of Michigan Medical School, Ann Arbor, MI, United States; Jeffrey J. Wing, Ohio State University, Columbus, OH, United States

Background: Previous studies have shown that people with sickle cell disease (SCD) are at significantly higher risk for venous thromboembolism (VTE) than age and sex-matched controls. However, these studies were performed in limited, cross-sectional, and primarily adult populations.

Objective: To describe the incidence rate of VTE among a population of children living with SCD and compare to those without SCD.

Design/Methods: Children < 18 years of age with SCD were identified from 2020-2022 through the Michigan Sickle Cell Data Collection (MiSCDC) program using validated methods. MiSCDC combines multiple sources of data to provide population-based health data for every individual living with SCD in Michigan, irrespective of engagement in care or insurance coverage. Using Michigan all payer discharge databases from 2020-2022, VTEs in the acute care setting were identified using ICD-10-CM diagnosis codes. The age-adjusted incidence rate of VTE and resulting 95% confidence interval (CI) was calculated using age groups of 0-4, 5-9, 10-14, and 15-17 years. The incidence rate for SCD was compared to the age-adjusted incidence rate of VTE for children that did not have SCD in Michigan using census data as the denominator. Finally, the three year cumulative incidence of VTE was calculated for adolescents ages 15-17 years.

Results: A total of 1,375 children with SCD contributed on average 2.7 years of observation (mean age = 8.7, 51.0% female). The age-adjusted incidence rate of VTE among children with SCD was 22.0 (95% CI: 14.4-29.7) per 10,000 person years, with the highest incidence rate occurring among those ages 15-17 years. In contrast, the age-adjusted incidence rate of VTE among children that did not have SCD was 1.2 (95% CI: 1.1-1.2) per 10,000 person years. The probability of an adolescent ages 15-17 with SCD developing a VTE in a three-year period was 0.4%.

Conclusion(s): Although VTEs are rare, the age-adjusted incidence rate of VTE for children with SCD was 18 times higher than for children without SCD. The higher rates among adolescents may reflect an increasing burden of thrombotic risk factors and SCD disease complications with age. Given data limitations, we were unable to account for presence of a central line at time of VTE. As VTE is an independent risk factor for VTE recurrence and mortality, future research is needed to understand predictors of VTE in a pediatric SCD population in order to optimally target prevention measures.