TITLE:
Assessment Implementation of Transcranial Doppler Imaging as a Screening Tool in Pediatrics with Sickle Cell in Prince Sultan Military Medical City
AUTHORS:
Reem Awdah Alanazi, Rafat Mohtasib, Omai AlSasi, Saud Missier Alfughim, Maha Jurais Alanazi, Amirah Awdah Alenezi, Kholoud Saeed Al Jarrah, Sultan Abdulrahman Alolit
KEYWORDS:
Stroke Prevention, Sickle Cell, Transcranial Doppler Imaging, TCDI
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.15 No.1,
February
21,
2025
ABSTRACT: Stroke is one of the irreversible neurological complications of sickle cell disease. Early diagnosis and appropriate treatment of neurological complications of sickle cell anemia require hematological and neurological expertise. Stroke prevention guidelines for sickle cell disease (SCD) recommend transcranial Doppler Imaging (TCDI) screening to identify children at risk for stroke. However, this study provides a baseline assessment of TCDI implementation rates as it is the first study of its kind in Prince Sultan Military Medical City. This study aimed to assess whether TCDI was successful or not as a screening tool to identify children at risk for stroke at Prince Sultan Military Medical City in Riyadh City, Saudi Arabia. From January 2023 to December 2023, a retrospective cohort study design was conducted. Ethical approval was obtained from the institutional board to waive the consent forms since it is a retrospective study and we are collecting normal routine data. Only the primary investigator had access to the patient’s medical records. The data will be extracted during the period from the initial launch of transcranial Doppler imaging TCDI as a screening tool tile January 2023. Variables collected from the hospital medical record department and a picture archiving and communication system (PACS), include the participants’ age at the TCDI initial transcranial screening exam and patient TCDI results which are categorized into 3 main categories: Normal (if the highest reading of Time Average Maximal Mean Velocity TAMMV) is less than 170 cm/sec and more than 70 cm/sec, Low conditional if the highest reading of TAMMV was more than 170 cm/sec and less than 200 cm/sec. High Conditional (Abnormal) which indicated the group at high risk of stroke if TAMMV highest velocity is more than 200 cm/sec and their recommended close follow up. The adherence to annual follow-ups in normally reported patients and close follow-ups with TCDI and confirmatory MRA/I is low conditional and abnormal once. Data was collected in an Excel sheet and analyzed using IBM SPSS Statistics 25 (SPSS, Inc., Chicago, IL). This study reflects a good level of compliance to TCDI follow-up and MRA/I among patients with abnormal results compared to those with normal results, where more efforts are needed to investigate barriers to adherence for successful implementation.