“Does the dose of hydroxyurea correlate with shorter hospital stay and higher fetal hemoglobin levels in patients with sickle cell disease?”

Background & Aims Sickle cell disease (SCD) leads to recurrent vaso-occlusive crises (VOC) and hospitalizations, imposing a substantial healthcare burden. Hydroxyurea (HU) is known to reduce VOC frequency and hospitalization rates in SCD; however, data comparing the impact of different HU doses on length of stay (LOS) and clinical outcomes in adults are limited.Methods This retrospective study assessed the effect of high- versus low-dose HU on LOS among adults with SCD admitted to medical wards. Secondary endpoints included VOC frequency and hemoglobin electrophoresis findings. Pearson’s chi-square and Mann–Whitney tests were used, with significance set at p < 0.05.Results A total of 141 patients were analyzed (26 on low-dose, 115 on high-dose HU), with a median age of 31 years; 52.5% were female. The overall median LOS was 3 days (IQR 1–10). The low-dose group had a significantly longer median LOS (7 days [IQR 7–9]) compared with the high-dose group (2 days [IQR 2–3]; p < 0.001). Higher HU doses were also associated with improved Hgb F% and Hgb S% (p < 0.001), while annual VOC rates showed no significant difference (p = 0.132).Conclusion High-dose HU was linked to shorter hospital stays and favorable hematologic outcomes in adults with SCD.