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Increased risk of severe vaso-occlusive episodes after initial acute chest syndrome in children with sickle cell anemia less than 4 years old: Sleep and asthma cohort

Increased risk of severe vaso-occlusive episodes after initial acute chest syndrome in children with sickle cell anemia less than 4 years old: Sleep and asthma cohort
Increased risk of severe vaso-occlusive episodes after initial acute chest syndrome in children with sickle cell anemia less than 4 years old: Sleep and asthma cohort

Previous studies have shown that the highest incidence of acute chest syndrome (ACS) in sickle cell disease occurs in children <4 years old, and a history of ACS at this age is a risk factor for future ACS episodes. However, the interval associated with the highest risk of subsequent ACS or severe pain is not known. Through this mixed retrospective-prospective observational study, the Sleep and Asthma Cohort, we sought to determine the interval after an initial ACS episode during which the majority of children <4 years old are rehospitalized for ACS or severe pain. The cumulative prevalence of rehospitalization for ACS or severe pain within 6 months, 1 years, and 2 years was calculated for children with an initial ACS episode <4 years old and compared to children with an initial ACS episode ≥4 years old. A total of 44.8% and 55.2% of participants had an initial ACS episode <4 years and ≥4 years old (Range: 4-17.7 years), respectively. At 1 year following the initial ACS episode, children <4 years old had a significantly higher cumulative prevalence of rehospitalizations for ACS or pain as compared to children ≥4 years of age, 62.5 and 39.1%, respectively (P = 0.009). After initial ACS episodes, the majority of children <4 years old will be rehospitalized for ACS or severe pain within one year, suggesting the need for a therapeutic intervention for this high-risk group.

Acute Chest Syndrome, Adolescent, Anemia, Sickle Cell, Asthma, Child, Child, Preschool, Female, Humans, Infant, Male, Pain, Patient Readmission, Prospective Studies, Retrospective Studies, Risk Factors, Sleep, Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
0361-8609
371-375
Vance, Leah D.
78901d1e-ffd1-4624-b5f5-3f13fca8c496
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Cohen, Robyn T.
68312680-d8a7-4a08-9e1e-2eff5e924bfe
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe
Vance, Leah D.
78901d1e-ffd1-4624-b5f5-3f13fca8c496
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Cohen, Robyn T.
68312680-d8a7-4a08-9e1e-2eff5e924bfe
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe

Vance, Leah D., Rodeghier, Mark, Cohen, Robyn T., Rosen, Carol L., Kirkham, Fenella J., Strunk, Robert C. and DeBaun, Michael R. (2015) Increased risk of severe vaso-occlusive episodes after initial acute chest syndrome in children with sickle cell anemia less than 4 years old: Sleep and asthma cohort. American Journal of Hematology, 90 (5), 371-375. (doi:10.1002/ajh.23959).

Record type: Article

Abstract

Previous studies have shown that the highest incidence of acute chest syndrome (ACS) in sickle cell disease occurs in children <4 years old, and a history of ACS at this age is a risk factor for future ACS episodes. However, the interval associated with the highest risk of subsequent ACS or severe pain is not known. Through this mixed retrospective-prospective observational study, the Sleep and Asthma Cohort, we sought to determine the interval after an initial ACS episode during which the majority of children <4 years old are rehospitalized for ACS or severe pain. The cumulative prevalence of rehospitalization for ACS or severe pain within 6 months, 1 years, and 2 years was calculated for children with an initial ACS episode <4 years old and compared to children with an initial ACS episode ≥4 years old. A total of 44.8% and 55.2% of participants had an initial ACS episode <4 years and ≥4 years old (Range: 4-17.7 years), respectively. At 1 year following the initial ACS episode, children <4 years old had a significantly higher cumulative prevalence of rehospitalizations for ACS or pain as compared to children ≥4 years of age, 62.5 and 39.1%, respectively (P = 0.009). After initial ACS episodes, the majority of children <4 years old will be rehospitalized for ACS or severe pain within one year, suggesting the need for a therapeutic intervention for this high-risk group.

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More information

Accepted/In Press date: 21 January 2015
e-pub ahead of print date: 23 January 2015
Published date: May 2015
Additional Information: © 2015 Wiley Periodicals, Inc.
Keywords: Acute Chest Syndrome, Adolescent, Anemia, Sickle Cell, Asthma, Child, Child, Preschool, Female, Humans, Infant, Male, Pain, Patient Readmission, Prospective Studies, Retrospective Studies, Risk Factors, Sleep, Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 419545
URI: https://eprints.soton.ac.uk/id/eprint/419545
ISSN: 0361-8609
PURE UUID: cb1de50d-e5b3-496d-b4d4-45a3442e80a6

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Date deposited: 13 Apr 2018 16:30
Last modified: 22 Oct 2018 16:31

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Contributors

Author: Leah D. Vance
Author: Mark Rodeghier
Author: Robyn T. Cohen
Author: Carol L. Rosen
Author: Fenella J. Kirkham
Author: Robert C. Strunk
Author: Michael R. DeBaun

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