J. Carmona-Tamayo1, J. Mitchell1, A. Zeineddin1, M. Tee1, C. Nembhard1 1Howard University College Of Medicine, Department Of Surgery, Washington, DC, USA
Introduction
The association between sickle cell anemia and thrombotic disease has been well described in previous studies. However, the effect of this relationship on the likelihood of acute thrombosis in patients with external hemorrhoids is not well understood. This study assesses the association between sickle cell anemia and emergency excision for thrombosed external hemorrhoids.
Methods
Using the Nationwide Emergency Department Sample (NEDS), patients diagnosed with thrombosed external hemorrhoids from 2009-2019 were identified. Multi-variable logistic regression was used to assess the effect of sickle cell anemia on the likelihood of emergency excision for thrombosed external hemorrhoids. Propensity score matching (1:5 ratio) was used to adjust for confounders such as age, sex, weekend admission, median household income quartile, and insurance status.
Results
A total of 1,368,952 patients diagnosed with thrombosed external hemorrhoids were identified. After propensity score matching 10,380 patients were selected for analysis. 3.3% (n = 36) underwent emergency excision, and 16.7% (n = 1730) of the patients identified had sickle cell anemia (Table 1). There was no statistically significant difference in the adjusted odds of excisional hemorrhoidectomy for patients with sickle cell anemia in comparison to those without the disease (OR 0.45, p = 0.190).
Conclusion
There was no statistically significant difference in the adjusted odds of excisional hemorrhoidectomy in patients with sickle cell anemia presenting with acute thrombosis of external hemorrhoids compared to those without the disease. Additional high-granularity studies to assess the risk factors for this presentation are necessary to better risk stratify patients with known external hemorrhoids.