The University of Southampton
University of Southampton Institutional Repository

Factors predicting future ACS episodes in children with sickle cell anemia

Factors predicting future ACS episodes in children with sickle cell anemia
Factors predicting future ACS episodes in children with sickle cell anemia

While a doctor-diagnosis of asthma is associated with an increased risk of pain and acute chest syndrome (ACS) in children with sickle cell anemia (SCA), little is known about the relationship between specific asthma characteristics and clinical factors and future morbidity in children with SCA. We evaluated the relationship between (i) asthma risk factors at the time of a clinical visit (respiratory symptoms, maternal history of asthma, allergy skin tests, spirometry results) and (ii) the known risk factor of ACS early in life, on prospective pain and ACS episodes in a cohort of 159 children with SCA followed from birth to a median of 14.7 years. An ACS episode prior to 4 years of age, (incidence rate ratio [IRR] = 2.84; P < 0.001], female gender (IRR = 1.80; P = 0.009), and wheezing causing shortness of breath (IRR = 1.68; P = 0.042) were associated with future ACS rates. We subsequently added spirometry results (obstruction defined as FEV1 /FVC less than the lower limits of normal; and bronchodilator response, FEV1 ≥ 12%) and prick skin test responses to the model. Only ≥ 2 positive skin tests had a significant effect (IRR 1.87; P = 0.01). Thus, early in life ACS events, wheezing causing shortness of breath, and ≥ 2 positive skin tests predict future ACS events.

Acute Chest Syndrome, Adolescent, Anemia, Sickle Cell, Asthma, Bronchodilator Agents, Child, Child, Preschool, Dyspnea, Female, Follow-Up Studies, Humans, Hypersensitivity, Immediate, Male, Prognosis, Prospective Studies, Respiratory Sounds, Risk Factors, Sickle Cell Trait, Skin Tests, Spirometry, beta-Thalassemia, Journal Article, Observational Study, Research Support, N.I.H., Extramural
0361-8609
E212-217
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Cohen, Robyn
68312680-d8a7-4a08-9e1e-2eff5e924bfe
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Roberts, Irene
6e025a6a-755f-4340-9a45-a99b0fde116b
Cooper, Ben
9873f2b7-0265-4d3f-8f8d-0d155381012b
Stocks, Janet
b2cd1933-aa00-483a-b996-74cdd2bfd09e
Wilkey, Olu
adb1eb81-8a3f-4966-820e-2d4d2d78a476
Inusa, Baba
830cfc6c-2482-4986-b2d3-9edd5cf2d9f5
Warner, John O.
50630e99-8486-4859-ade3-cd2c79c5a153
Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Cohen, Robyn
68312680-d8a7-4a08-9e1e-2eff5e924bfe
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Roberts, Irene
6e025a6a-755f-4340-9a45-a99b0fde116b
Cooper, Ben
9873f2b7-0265-4d3f-8f8d-0d155381012b
Stocks, Janet
b2cd1933-aa00-483a-b996-74cdd2bfd09e
Wilkey, Olu
adb1eb81-8a3f-4966-820e-2d4d2d78a476
Inusa, Baba
830cfc6c-2482-4986-b2d3-9edd5cf2d9f5
Warner, John O.
50630e99-8486-4859-ade3-cd2c79c5a153
Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d

DeBaun, Michael R., Rodeghier, Mark, Cohen, Robyn, Kirkham, Fenella J., Rosen, Carol L., Roberts, Irene, Cooper, Ben, Stocks, Janet, Wilkey, Olu, Inusa, Baba, Warner, John O. and Strunk, Robert C. (2014) Factors predicting future ACS episodes in children with sickle cell anemia. American Journal of Hematology, 89 (11), E212-217. (doi:10.1002/ajh.23819).

Record type: Article

Abstract

While a doctor-diagnosis of asthma is associated with an increased risk of pain and acute chest syndrome (ACS) in children with sickle cell anemia (SCA), little is known about the relationship between specific asthma characteristics and clinical factors and future morbidity in children with SCA. We evaluated the relationship between (i) asthma risk factors at the time of a clinical visit (respiratory symptoms, maternal history of asthma, allergy skin tests, spirometry results) and (ii) the known risk factor of ACS early in life, on prospective pain and ACS episodes in a cohort of 159 children with SCA followed from birth to a median of 14.7 years. An ACS episode prior to 4 years of age, (incidence rate ratio [IRR] = 2.84; P < 0.001], female gender (IRR = 1.80; P = 0.009), and wheezing causing shortness of breath (IRR = 1.68; P = 0.042) were associated with future ACS rates. We subsequently added spirometry results (obstruction defined as FEV1 /FVC less than the lower limits of normal; and bronchodilator response, FEV1 ≥ 12%) and prick skin test responses to the model. Only ≥ 2 positive skin tests had a significant effect (IRR 1.87; P = 0.01). Thus, early in life ACS events, wheezing causing shortness of breath, and ≥ 2 positive skin tests predict future ACS events.

Full text not available from this repository.

More information

Accepted/In Press date: 31 July 2014
e-pub ahead of print date: 2 August 2014
Published date: November 2014
Additional Information: © 2014 Wiley Periodicals, Inc.
Keywords: Acute Chest Syndrome, Adolescent, Anemia, Sickle Cell, Asthma, Bronchodilator Agents, Child, Child, Preschool, Dyspnea, Female, Follow-Up Studies, Humans, Hypersensitivity, Immediate, Male, Prognosis, Prospective Studies, Respiratory Sounds, Risk Factors, Sickle Cell Trait, Skin Tests, Spirometry, beta-Thalassemia, Journal Article, Observational Study, Research Support, N.I.H., Extramural

Identifiers

Local EPrints ID: 419543
URI: https://eprints.soton.ac.uk/id/eprint/419543
ISSN: 0361-8609
PURE UUID: d45c59ad-08c9-4fd3-ae7d-6733b7d9f4a3
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

Catalogue record

Date deposited: 13 Apr 2018 16:30
Last modified: 20 Jul 2019 01:05

Export record

Altmetrics

Contributors

Author: Michael R. DeBaun
Author: Mark Rodeghier
Author: Robyn Cohen
Author: Fenella J. Kirkham ORCID iD
Author: Carol L. Rosen
Author: Irene Roberts
Author: Ben Cooper
Author: Janet Stocks
Author: Olu Wilkey
Author: Baba Inusa
Author: John O. Warner
Author: Robert C. Strunk

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×