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Lower airway obstruction is associated with increased morbidity in children with sickle cell disease

Jessica H Boyd1, Michael R DeBaun, Wayne J Morgan

  • 1Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA. boyd_j@kids.wustl.edu

Pediatric Pulmonology
|February 11, 2009
PubMed

Insights

Children with sickle cell disease (SCD) and lower airway obstruction experience twice the rate of pain or acute chest syndrome (ACS) hospitalizations. Increased surveillance is recommended for these children to monitor for future health issues.

Area of Science:

  • Pediatric Pulmonology
  • Hematology
  • Clinical Medicine

Background:

  • Pulmonary function abnormalities are not well-studied in relation to morbidity in pediatric sickle cell disease (SCD).
  • Morbidity in SCD is often assessed by hospitalizations for pain or acute chest syndrome (ACS).

Purpose of the Study:

  • To investigate the association between pulmonary function test results and the incidence of pain or ACS hospitalizations in children with SCD.
  • To determine if specific pulmonary function abnormalities predict future morbidity events in this population.

Main Methods:

  • Pulmonary function tests (PFTs) were performed on children aged 6-18 years with SCD.
  • PFT results were categorized into lower airway obstruction, restriction, or normal lung function.
  • Hospitalization rates for pain or ACS were compared between groups with abnormal PFTs and those with normal PFTs.

Main Results:

  • Children with lower airway obstruction had a significantly higher rate of hospitalizations for pain or ACS (2.5 vs. 1.2 per patient-year, RR 2.0, P=0.003).
  • No significant difference in morbidity rates was observed for children with restrictive lung function compared to those with normal lung function (1.4 vs. 1.2 per patient-year, RR 1.1, P=0.68).

Conclusions:

  • Lower airway obstruction in children with SCD is associated with increased future morbidity, specifically pain or ACS hospitalizations.
  • Children with SCD and lower airway obstruction warrant closer monitoring and increased surveillance for adverse health events.
Abstract

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