Children with sickle cell disease hospitalized for acute pancreatitis have an increased disease burden.

Abstract

Objectives: Children with sickle cell disease (SCD) are at increased risk of developing gallstones, a common etiology of acute pancreatitis (AP). We aimed to determine if children with SCD admitted to children's hospitals for AP will have an increased burden of AP compared to non-SCD.

Methods: Retrospective study of children 0-21 years admitted with a diagnosis of AP in the Pediatric Health Information System (PHIS) database from 2012 to 2023. Descriptive statistics were used to describe baseline demographics. Categorical variables including readmissions, complications, transfusions, and procedure rates were compared between groups (SCD vs. non-SCD) using χ² or Fisher's exact test. Wilcoxon rank sum test was used to compare the median age and length of stay (LOS) between groups.

Results: We analyzed 18,213 distinct participants (17,927 [non-SCD] and 286 [SCD]). Children with SCD were older; p = 0.0004 compared to non-SCD. Children with SCD had increased LOS compared to those without SCD; 4 versus 3 days, p = <0.001. Further, children with SCD received more transfusions compared to those without SCD (31% vs. 3%; p = <0.0001). Need for endoscopic interventions in SCD was 21% versus 8% in non-SCD (p < 0.0001), and cholecystectomy rates were higher in SCD, 33% compared to 11% in non-SCD (p < 0.0001).

Conclusions: Children with SCD hospitalized with AP at children's hospitals are older, need more red blood cell transfusions, have an increased LOS, and need more procedures compared to children without SCD. Further studies aimed at reducing the burden of AP in children with SCD are needed.