Alkindi et al identified clinical factors associated with the acute chest syndrome (ACS) in a patient with sickle cell disease. The authors are from Sultan Qaboos University in Oman and Thomas Jefferson University.
Patient selection: adolescent or adult with sickle cell disease
Findings more common in patients with acute chest syndrome:
(1) asplenia (odds ratio 7.0)
(2) fever (> 37.8°C; odds ratio 4.0)
(3) reduced oxygen saturation (< 95%; odds ratio 8.1)
(4) low hemoglobin (odds ratio 0.535; anemia associated with reduced risk)
(5) leukocytosis (odds ratio 1.2)
Findings associated with severity of the acute chest syndrome:
(1) pleural effusion
(2) multi-lobar consolidation on CT scan
(3) non-invasive ventilation
(4) transfusion
(4a) exchange transfusions
(4b) simple blood transfusions
