Risk stratification of vaso-occlusive crises in sickle cell anemia using redox biomarkers
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Introduction: The clinical manifestations of sickle cell anemia are highly heterogeneous, making it difficult to predict acute events. Establishing associations between biochemical markers and the risk of acute complications is essential. Redox status plays a crucial role in the pathophysiology of the disease and may be a predictive biomarker for vaso-occlusive crises.Objective: To Apply a risk scale based on redox status biomarkers (reduced glutathione and malondialdehyde) in the risk stratification of vaso-occlusive crises in a cohort of patients with sickle cell anemia in Santiago de Cuba.Methods: A longitudinal analytical study was carried out in 72 patients with sickle cell anemia in Santiago de Cuba between July and December 2022. A risk scale derived from linear discriminant analysis was applied using malondialdehyde and reduced glutathione concentrations. The discriminatory capacity of the scale was evaluated using the area under the ROC curve.Results: The scale showed a strong and significant association with clinical status (p<0.001). The simplified scale demonstrated excellent discriminatory ability (AUC of 0.957). Sensitivity and negative predictive value were both 100 %, correctly identifying all patients who developed complications. Specificity was 90.9 %. Conclusions: The applied risk scale demonstrates robust performance and high negative predictive value in this cohort. Its implementation allows for the risk stratification of vaso-occlusive crises in sickle cell anemia.
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Copyright (c) 2026 Yamirka Alonso-Geli, Haydeé Cruz Vadell , Lidia Clara Suárez Beyríes , Celeste Roque Rodríguez , Manuel Arsenio Lores Guevara
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