Faculty Collaboration Database

Venous incompetence, poverty and lactate dehydrogenase in Jamaica are important predictors of leg ulceration in sickle cell anaemia. Br J Haematol 2008 Jul;142(1):119-25

Date

05/15/2008

Pubmed ID

18477043

DOI

10.1111/j.1365-2141.2008.07115.x

Scopus ID

2-s2.0-44649092159 (requires institutional sign-in at Scopus site)   50 Citations

Abstract

Clinical features and potential risk factors for chronic leg ulceration (duration >6 months) in homozygous sickle cell (SS) disease were examined in 225 subjects in the Jamaican Cohort Study. Potential risk factors included the number of HBA genes, steady state haematology, serum lactate dehydrogenase (LDH), venous incompetence, and socio-economic status. Chronic ulcers occurred in 53 subjects with the highest risk of ulcer development at 18 years. The prevalence was 29.5% and cumulative incidence 16.7%. Gender or alpha-thalassaemia trait did not affect the incidence of leg ulcer. Ulceration was associated with lower haemoglobin, red cell count, fetal haemoglobin, and socio-economic status and higher reticulocyte count, platelet count, serum LDH and venous incompetence in univariate analyses. Venous incompetence [Hazard Ratio (HR) 3.0-4.0] and socio-economic status (HR 0.8) were most consistently associated with leg ulceration on multivariate analysis. Regression models incorporating serum LDH suggested this to be a stronger predictor than haematological indices. The prevalence of ulcers at 30% is less than previous estimates in Jamaica, probably reflecting the lack of ascertainment bias in the Cohort Study, and also a real secular decline. In Jamaica, venous incompetence, low socio-economic status, and high serum LDH were the strongest predictors of chronic ulceration.

Author List

Cumming V, King L, Fraser R, Serjeant G, Reid M

Author

Raphael Fraser PhD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age of Onset
Aged
Anemia, Sickle Cell
Chronic Disease
Female
Humans
Jamaica
L-Lactate Dehydrogenase
Leg Ulcer
Male
Middle Aged
Poverty
Risk Factors
Venous Insufficiency
Young Adult