Sudden Deaths associated with Sickle-Cell Trait in US Military Service Members, 1995 to 2011

Previous studies examined the relationship between Sickle-Cell trait (SCT) and the outcome of sudden death in military recruits and showed an association between SCT and a higher incidence of exercise-related sudden death unexplained by any known pre-existing cause. Increased risks of sudden death were related to exertional heat illness, exertional rhabdomyolysis and exertional acute renal failure. Since the 1980's the Department of Defense revised health policy by implementing measures to reduce the risk of previously mentioned outcomes. The current analysis will describe demographic characteristics and death rates from 1995-2011 in active military service members, with or without sickle cell trait, and examine the association of sickle cell trait with sudden deaths during exertion. The Defense Medical Surveillance System (DMSS) was used to obtain all active component service members in the Armed Forces during the surveillance period. Inpatient, outpatient and casualty records were used to identify service members with SCT and Sudden Death using ICD9 diagnoses. Demographic characteristics at the time of death and mortality rates were calculated using SAS software. The results overall show no sudden deaths in military service members with Sickle cell trait. In contrast, previous research demonstrated an increased risk in association between sickle cell trait and sudden death. As a result of recruitment and health policy reform, the Armed Forces have implemented measures of prevention that appear to improve health outcomes for service members at risk and can be considered a model for the implementation of certain health policies related to similar demographic and athletic populations.