Assessing Pain and Identifying Characteristics that Predict Pain Locations in Saudi Arabian Sickle Cell Disease Patients

Abstract

Background: Pain is a common and a serious problem in the sickle cell disease (SCD) population. However, research on pain locations and their predictors is lacking in Saudi Arabian SCD patients. We sought to assess pain and identify characteristics that predict pain locations in a sample of Saudi patients with SCD. 

Methods: A cross-sectional retrospective study was conducted on 290 patients with SCD who attended King Fahad Hospital, Hofuf, Saudi Arabia for routine checkups between October 2016 and March 2017. SCD symptoms and pain locations were collected through structured interviews and blood tests results were retrieved from patient charts during the previous six months. 

Results: The sample’s mean age was 29.1 (±SD 10.2) years. Pain was commonly reported in 96.9% of patients (95% CI: 94.2% – 98.6%). Pain location distribution was as follows: leg pain 75.2%, back pain 64.1%, chest pain 39.3%, and arm pain 37.9%. Shortness of breath was the only independent predictor of chest pain (aOR=3.42). The independent predictors of back pain were: high (>11 ×10⁹ cells/liter) white blood cell counts (aOR=1.92) and skin redness (aOR=4.87). Hemoglobin A2 (aOR=1.39), tiredness (aOR=2.07), and frequent ED visits (aOR=2.22) were the primary predictors of arm pain. 

Conclusions: We noted a substantially high frequency of pain in a sample of Saudi patients with SCD. The study also recognizes that pain was relatively stronger among patients with high white blood cell (WBC) counts. Hence, interventions to alter the WBC count could be implemented to reduce pain in SCD patients.