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Hot Off the Press: Which Febrile Children With Sickle Cell Disease Need a Chest X-Ray?
Justin Morgenstern1, Corey Heitz2, William K Milne3
1Department of Emergency Medicine, Markham Stouffville Hospital, Markham, Ontario, Canada.
Insights
This study analyzed febrile children with sickle cell disease, finding that acute chest syndrome (ACS) occurred in 10% of emergency department visits. It identified key clinical factors predicting ACS diagnosis in pediatric patients.
Area of Science:
- Pediatric Hematology
- Emergency Medicine
- Clinical Informatics
Background:
- Sickle cell disease (SCD) is a genetic blood disorder.
- Acute Chest Syndrome (ACS) is a common and serious complication of SCD.
- Febrile episodes in children with SCD require prompt evaluation for ACS.
Purpose of the Study:
- To determine the incidence of ACS in febrile children with SCD.
- To identify clinical factors that predict the diagnosis of ACS in this population.
- To improve diagnostic accuracy for ACS in pediatric SCD patients.
Main Methods:
- Retrospective chart review of pediatric emergency department visits.
- Inclusion criteria: febrile children (3 months to 21 years) with SCD.
- Recursive partitioning analysis to identify predictive clinical factors for ACS.
Main Results:
- Over 2 years, 1,837 visits by 697 children with SCD were reviewed.
- Acute Chest Syndrome (ACS) was diagnosed in 185 visits (10% incidence).
- Specific clinical factors were identified as predictive of ACS (details not provided in abstract).
Conclusions:
- Febrile children with sickle cell disease have a significant risk of developing ACS.
- Identifying predictive clinical factors can aid in the early diagnosis of ACS.
- Further research is warranted to refine predictive models for ACS in pediatric SCD.
Abstract:
This retrospective chart review examined the rate of acute chest syndrome (ACS) in febrile children (aged 3 months to 21 years) with sickle cell disease and used recursive partitioning to determine which clinical factors were predictive of a diagnosis of ACS. Over the course of 2 years, 697 children made 1,837 visits to one of two pediatric emergency departments. ACS was diagnosed in 185 (10%) of the visits.
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