Pattern and Risk Factors for Musculoskeletal Complications of Sickle Cell Anaemia in South-East Nigeria: A Retrospective Study

Aims: To determine the pattern and associated risk factors for musculoskeletal complications among sickle cell anaemia patients in South-east Nigeria.
Methodology: A retrospective review of prospectively collected data. The study was conducted at the Sickle Cell Clinic of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria between December 31st 2004 and January 1st 2013. We included 163 eligible sickle cell anaemia patients (105 males and 58 females; age range 6-53 years). Clinical, haematological (haemoglobin, white cell count, platelet) and radiological evaluation of these patients were done. Data analysis was by SPSS version 19. Chi-square and Fisher’s exact tests were used to test for significant association of the categorical variables while Mann Whitney U test was used to compare the mean ranks of the continuous variables and the dependent outcome.
Results: The three most common musculoskeletal complications seen among our patients population were leg ulcer (29.4%), avascular necrosis (17.8%) and osteomyelitis (12.9%). Complications were significantly more in older patients (P=0.04) and those with higher platelet counts (P=0.04). Haemoglobin level and platelet count were significantly higher in patients with avascular necrosis (P=0.01) and osteomyelitis respectively (P=0.01).
Conclusion: Musculoskeletal complications of SCA are not uncommon among our patients. Age and higher steady state haemoglobin were risk factors for developing complications. Further controlled studies are required to evaluate the steady state hematological parameters and risk of complications among SCA patients.