Male gender alone may be a bad prognostic factor in sickle cell diseases

Mehmet Rami Helvaci1, Valeria Pappel2, Kubra Piral2, Selim Ozer2,
Mehpare Camlibel3, Huseyin Sencan1, Ramazan Davran4, Abdulrazak Abyad5,
Lesley Pocock6

(1) Specialist of Internal Medicine, MD, Turkey
(2) Manager of Writing and Statistics, Turkey
(3) Specialist of Emergency Medicine, MD, Turkey
(4) Specialist of Radiology, MD, Turkey
(5) Middle-East Academy for Medicine of Aging, MD, Lebanon
(6) edi-WORLD International, Australia

Corresponding author:
Prof Dr Mehmet Rami Helvaci, MD
07400, ALANYA, Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com

Received: August 2023; Accepted: September2023; Published: October 2023
Citation: Helvaci MR et al. Male gender alone may be a bad prognostic factor in sickle cell diseases. Middle East Journal of Nursing 2023; 17(2): 39-52. DOI: 10.5742/MEJN2023.9378043

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ABSTRACT

Background: Sickle cell diseases are inborn and destructive processes on vascular endothelium, particularly at the capillaries.

Methods: All patients were included.

Results: We studied 222 males and 212 females with similar ages (30.8 vs 30.3 years, p>0.05, respectively). Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBCs) in their lives (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% vs 7.0%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), cirrhosis (8.1% vs 1.8%, p<0.001), leg ulcers (19.8% vs 7.0%, p<0.001), clubbing (14.8% vs 6.6%, p<0.001), coronary heart disease (CHD) (18.0% vs 13.2%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), and stroke (12.1% vs 7.5%, p<0.05) were all higher, and autosplenectomy (50.4% vs 53.3%, p<0.05) and mean age of mortality were lower in males (30.2 vs 33.3 years, p<0.05).

Conclusion: The sickled or just hardened RBCs-induced capillary endothelial damage initiates at birth, and terminates with multiorgan failures even at childhood. Although RBCs suspensions and corticosteroids in acute, and aspirin with an anti-inflammatory dose plus low-dose warfarin plus hydroxyurea both in acute and chronic phases decrease severity, survivals are still shortened in both genders, dramatically. Transfused units of RBCs in their lives, disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, clubbing, CHD, CRD, and stroke were all higher, and autosplenectomy and mean age of mortality were lower in males which can not be explained by effects of smoking and alcohol alone at these younger mean ages, relatively.

Key words: Sickle cell diseases, sickled or just hardened red blood cells, capillary endothelial edema, myocardial infarction, stroke, sudden deaths, male gender