Characteristics of acute chest syndrome patients.*
| . | Age at First Episode of Acute Chest Syndrome . | ||||
|---|---|---|---|---|---|
| Characteristic . | All Pts.(n=537) . | 0-9 yr(n=264) . | 10-19 yr(n=145) . | >20 yr(n=128) . | P Value** . |
| * Because of rounding, percentages may not total 100. Data on one patient were excluded because the patient’s birth date was not known. | |||||
| ** P values were calculated by chi-square analyses. | |||||
| + Other reasons included a vaso-occlusive event, anemia, fever, infection, gastrointestinal or abdominal pain, asthma, urologic and orthopedic conditions, heart failure, and surgery. | |||||
| Reprinted with permission from Vichinsky E et al. Causes and outcomes of the acute chest syndrome in sickle cell disease. N Engl J Med. 2000;342:1855-65. | |||||
| Sex (%) | |||||
| Male | 58 | 63 | 57 | 48 | 0.02 |
| Female | 42 | 38 | 43 | 53 | |
| Hemoglobinopathy (%) | |||||
| SS | 82 | 83 | 81 | 83 | 0.94 |
| Other | 18 | 17 | 19 | 17 | |
| Mean age at first episode of acute chest syndrome (yr) | 13.8 | 5.4 | 14.6 | 30.2 | <0.001 |
| Medical history (%) | |||||
| Vaso-occlusive event | 80 | 72 | 85 | 89 | <0.001 |
| Transfusion | 74 | 63 | 84 | 86 | <0.001 |
| Acute chest syndrome or pneumonia | 67 | 63 | 66 | 76 | 0.03 |
| Prophylactic antibiotic therapy | 57 | 81 | 51 | 13 | <0.001 |
| Major surgery | 40 | 26 | 48 | 61 | <0.001 |
| Neurologic disease | 16 | 10 | 17 | 29 | <0.001 |
| Sleep apnea | 14 | 14 | 17 | 11 | 0.41 |
| Red-cell antibodies | 12 | 7 | 13 | 21 | <0.001 |
| Aseptic necrosis or fracture | 12 | 5 | 11 | 26 | <0.001 |
| Asthma | 11 | 14 | 9 | 5 | <0.001 |
| Smoking | 10 | 0 | 4 | 36 | <0.001 |
| Renal disease or urinary tract infection | 7 | 3 | 7 | 14 | <0.001 |
| Chronic transfusion therapy | 5 | 5 | 5 | 7 | 0.64 |
| Cardiac disease | 4 | 1 | 3 | 12 | <0.001 |
| Chronic lung disease | 4 | 3 | 4 | 5 | 0.46 |
| Pulmonary edema | 4 | 1 | 3 | 9 | <0.001 |
| Clubbing | 2 | 1 | 0 | 5 | 0.002 |
| Deep-vein thrombosis | 1 | <1 | 0 | 3 | 0.01 |
| Tuberculosis | <1 | 0 | 0 | 1 | 0.20 |
| Reason for current admission (%) | |||||
| Acute chest syndrome | 52 | 61 | 46 | 42 | <0.001 |
| Other+ | 48 | 39 | 54 | 58 | |
| Symptoms at diagnosis of acute chest syndrome (%) | |||||
| Fever | 80 | 86 | 78 | 70 | <0.001 |
| Cough | 62 | 69 | 58 | 54 | 0.006 |
| Chest pain | 44 | 27 | 67 | 55 | <0.001 |
| Tachypnea | 45 | 47 | 67 | 55 | <0.001 |
| Shortness of breath | 41 | 31 | 44 | 58 | <0.001 |
| Pain in arms and legs | 37 | 22 | 44 | 59 | <0.001 |
| Abdominal pain | 35 | 38 | 36 | 29 | 0.24 |
| Rib or sternal pain | 21 | 14 | 26 | 30 | <0.001 |
| Reactive airway disease | 13 | 17 | 12 | 6 | 0.01 |
| Neurologic dysfunction | 4 | 3 | 3 | 7 | 0.11 |
| Cyanosis | 2 | 1 | 3 | 3 | 0.24 |
| Heart failure | 1 | 2 | 1 | 1 | 0.49 |
| . | Age at First Episode of Acute Chest Syndrome . | ||||
|---|---|---|---|---|---|
| Characteristic . | All Pts.(n=537) . | 0-9 yr(n=264) . | 10-19 yr(n=145) . | >20 yr(n=128) . | P Value** . |
| * Because of rounding, percentages may not total 100. Data on one patient were excluded because the patient’s birth date was not known. | |||||
| ** P values were calculated by chi-square analyses. | |||||
| + Other reasons included a vaso-occlusive event, anemia, fever, infection, gastrointestinal or abdominal pain, asthma, urologic and orthopedic conditions, heart failure, and surgery. | |||||
| Reprinted with permission from Vichinsky E et al. Causes and outcomes of the acute chest syndrome in sickle cell disease. N Engl J Med. 2000;342:1855-65. | |||||
| Sex (%) | |||||
| Male | 58 | 63 | 57 | 48 | 0.02 |
| Female | 42 | 38 | 43 | 53 | |
| Hemoglobinopathy (%) | |||||
| SS | 82 | 83 | 81 | 83 | 0.94 |
| Other | 18 | 17 | 19 | 17 | |
| Mean age at first episode of acute chest syndrome (yr) | 13.8 | 5.4 | 14.6 | 30.2 | <0.001 |
| Medical history (%) | |||||
| Vaso-occlusive event | 80 | 72 | 85 | 89 | <0.001 |
| Transfusion | 74 | 63 | 84 | 86 | <0.001 |
| Acute chest syndrome or pneumonia | 67 | 63 | 66 | 76 | 0.03 |
| Prophylactic antibiotic therapy | 57 | 81 | 51 | 13 | <0.001 |
| Major surgery | 40 | 26 | 48 | 61 | <0.001 |
| Neurologic disease | 16 | 10 | 17 | 29 | <0.001 |
| Sleep apnea | 14 | 14 | 17 | 11 | 0.41 |
| Red-cell antibodies | 12 | 7 | 13 | 21 | <0.001 |
| Aseptic necrosis or fracture | 12 | 5 | 11 | 26 | <0.001 |
| Asthma | 11 | 14 | 9 | 5 | <0.001 |
| Smoking | 10 | 0 | 4 | 36 | <0.001 |
| Renal disease or urinary tract infection | 7 | 3 | 7 | 14 | <0.001 |
| Chronic transfusion therapy | 5 | 5 | 5 | 7 | 0.64 |
| Cardiac disease | 4 | 1 | 3 | 12 | <0.001 |
| Chronic lung disease | 4 | 3 | 4 | 5 | 0.46 |
| Pulmonary edema | 4 | 1 | 3 | 9 | <0.001 |
| Clubbing | 2 | 1 | 0 | 5 | 0.002 |
| Deep-vein thrombosis | 1 | <1 | 0 | 3 | 0.01 |
| Tuberculosis | <1 | 0 | 0 | 1 | 0.20 |
| Reason for current admission (%) | |||||
| Acute chest syndrome | 52 | 61 | 46 | 42 | <0.001 |
| Other+ | 48 | 39 | 54 | 58 | |
| Symptoms at diagnosis of acute chest syndrome (%) | |||||
| Fever | 80 | 86 | 78 | 70 | <0.001 |
| Cough | 62 | 69 | 58 | 54 | 0.006 |
| Chest pain | 44 | 27 | 67 | 55 | <0.001 |
| Tachypnea | 45 | 47 | 67 | 55 | <0.001 |
| Shortness of breath | 41 | 31 | 44 | 58 | <0.001 |
| Pain in arms and legs | 37 | 22 | 44 | 59 | <0.001 |
| Abdominal pain | 35 | 38 | 36 | 29 | 0.24 |
| Rib or sternal pain | 21 | 14 | 26 | 30 | <0.001 |
| Reactive airway disease | 13 | 17 | 12 | 6 | 0.01 |
| Neurologic dysfunction | 4 | 3 | 3 | 7 | 0.11 |
| Cyanosis | 2 | 1 | 3 | 3 | 0.24 |
| Heart failure | 1 | 2 | 1 | 1 | 0.49 |