Contributions
Abstract: PB1766
Type: Publication Only
Session title: Sickle cell disease
Background
Epidemiological 2010-2050 predictions of increasing global burden, make SCD an emerging problem of public health. The distribution of SCD patients in Italy has severely changed in the last decade due to a combination of migration fluxes and increased survival of the endemic population.
Aims
To understand the evolution of SCD disease burden in Italy, we designed a non-interventional retrospective cohort study with secondary use of administrative data (GREATalyS; CSEG101AIT01). Our objective is to collect representative data generalizable to the total Italian population to estimate prevalence and incidence rates of SCD in clinical practice settings.
Methods
An observational retrospective analysis was conducted by integrating administrative NHS databases for healthcare resources consumption from a geographically distributed sample of Italian Regions and Local Health Units (LHUs) comprising approximately 15.3 million health-assisted subjects (about 25% of the whole Italian population). Patients with at least one hospitalization (day hospital or regular admission) with a main or secondary discharge SCD diagnosis (identified by ICD-9-CM codes) were included in the analyses (period: January 2010-December 2018). Analyses of prevalence and incidence were stratified by age, sex and presence/absence of crisis (based on diagnosis at inclusion). Data were then projected to the total Italian population.
Results
Out of 15.3 million health-assisted subjects, 2,347 patients fulfilled the inclusion criteria during the full study period. The calculated SCD prevalence in 2018 was around 13 cases per 100,000 health-assisted subjects (around 11 cases per 100,000 males and 15 per 100,000 females were observed). SCD prevalence in young (<18 years old) and adult population was 17.2 and 12.4 cases per 100,000 health-assisted individuals, respectively. When projected to the total Italian population, 7,977 SCD patients were estimated in 2018 (1,690 young and 6,287 adult patients) (Figure 1).
Incidence rates slightly fluctuate over the years (from 2.00 per 100,000 health assisted in 2011 to 0.93 per 100,000 in 2018 corresponding to 567 new diagnosis in 2018).
Approximately two third (74%) of the patients had at least one hospitalization during study without a concomitant diagnosis of crisis (5,894 without/1,279 with, 804 unspecified), thus suggestive of a high disease burden beyond severe VOC. SCD “With crisis” prevalence was higher in patients aged <45 years, ranging from 2.45 (age group 35-44) to 3.04 (age group 25-29) and decreased significantly after 54 years to a minimum of 0.34 in patients aged 75-84 years. Geographical stratification showed a 'population without crisis' almost doubled in the Southern areas (12.44 cases per 100,000) compared to the North (6.93 cases per 100,000) and Center (4.34 cases per 100,000) areas.
Conclusion
GREATalyS identified a high SCD incidence and prevalence resulting in a total of 7,977 Italian SCD patients estimated in 2018, when considering the long observation period. The discrepancy between the prevalence herein reported with previous SCD epidemiology analysis (around 2,000 SCD patients in Italy) might be explained by the real world setting of our analysis which considers also patients not referred to specialist centers, potentially underreported in Italy. Hence, this data represents the highly variable presentation of SCD and shed light on the management of patients not generally described in the literature.
Keyword(s): Epidemiology, Sickle cell disease
Abstract: PB1766
Type: Publication Only
Session title: Sickle cell disease
Background
Epidemiological 2010-2050 predictions of increasing global burden, make SCD an emerging problem of public health. The distribution of SCD patients in Italy has severely changed in the last decade due to a combination of migration fluxes and increased survival of the endemic population.
Aims
To understand the evolution of SCD disease burden in Italy, we designed a non-interventional retrospective cohort study with secondary use of administrative data (GREATalyS; CSEG101AIT01). Our objective is to collect representative data generalizable to the total Italian population to estimate prevalence and incidence rates of SCD in clinical practice settings.
Methods
An observational retrospective analysis was conducted by integrating administrative NHS databases for healthcare resources consumption from a geographically distributed sample of Italian Regions and Local Health Units (LHUs) comprising approximately 15.3 million health-assisted subjects (about 25% of the whole Italian population). Patients with at least one hospitalization (day hospital or regular admission) with a main or secondary discharge SCD diagnosis (identified by ICD-9-CM codes) were included in the analyses (period: January 2010-December 2018). Analyses of prevalence and incidence were stratified by age, sex and presence/absence of crisis (based on diagnosis at inclusion). Data were then projected to the total Italian population.
Results
Out of 15.3 million health-assisted subjects, 2,347 patients fulfilled the inclusion criteria during the full study period. The calculated SCD prevalence in 2018 was around 13 cases per 100,000 health-assisted subjects (around 11 cases per 100,000 males and 15 per 100,000 females were observed). SCD prevalence in young (<18 years old) and adult population was 17.2 and 12.4 cases per 100,000 health-assisted individuals, respectively. When projected to the total Italian population, 7,977 SCD patients were estimated in 2018 (1,690 young and 6,287 adult patients) (Figure 1).
Incidence rates slightly fluctuate over the years (from 2.00 per 100,000 health assisted in 2011 to 0.93 per 100,000 in 2018 corresponding to 567 new diagnosis in 2018).
Approximately two third (74%) of the patients had at least one hospitalization during study without a concomitant diagnosis of crisis (5,894 without/1,279 with, 804 unspecified), thus suggestive of a high disease burden beyond severe VOC. SCD “With crisis” prevalence was higher in patients aged <45 years, ranging from 2.45 (age group 35-44) to 3.04 (age group 25-29) and decreased significantly after 54 years to a minimum of 0.34 in patients aged 75-84 years. Geographical stratification showed a 'population without crisis' almost doubled in the Southern areas (12.44 cases per 100,000) compared to the North (6.93 cases per 100,000) and Center (4.34 cases per 100,000) areas.
Conclusion
GREATalyS identified a high SCD incidence and prevalence resulting in a total of 7,977 Italian SCD patients estimated in 2018, when considering the long observation period. The discrepancy between the prevalence herein reported with previous SCD epidemiology analysis (around 2,000 SCD patients in Italy) might be explained by the real world setting of our analysis which considers also patients not referred to specialist centers, potentially underreported in Italy. Hence, this data represents the highly variable presentation of SCD and shed light on the management of patients not generally described in the literature.
Keyword(s): Epidemiology, Sickle cell disease