Score of Bartolucci et al for Predicting the Acute Chest Syndrome During a Sickle Cell Vaso-Occlusive Crisis

Description

Bartolucci et al developed a score for predicting the risk of the acute chest syndrome developing in an adult sickle cell patient with a vaso-occlusive crisis (VOC). This can help to decide if the patient can be discharged or if the patient should receive more aggressive management. The authors are from Henri-Mondor Hospital-UPEC in Creteil, France.

Patient selection: adult patient with sickle cell disease experiencing a vaso-occlusive crisis (VOC)

Outcome: acute chest syndrome (ACS)

Parameters:

(1) absolute reticulocyte count in 10^9/L

(2) categorical pain score in spine and/or pelvis

(3) leukocyte (WBC) count in 10^9/L

(4) hemoglobin in g/dL

Categorical Pain	Score
none	0
mild, not increased by mobilization	1
moderate, increased by mobilization	2
severe, with disability	3

Parameter	Finding	Points
absolute reticulocyte count	<= 216 * 10^9/L	0
	> 216 * 10^9/L	6
categorical pain score	0 or 1	0
	2	4
	3	6
leukocyte count	<= 11 * 10^9/L	0
	> 11 * 10^9/L	3
hemoglobin	> 9 g/dL	0
	<= 9 g/dL	1

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 16

• The higher the score the greater the risk of the acute chest syndrome (ACS).

Total Score	Risk ACS
0 to 5	low
6 to 10	intermediate
11 to 16	high

Performance:

• The area under the ROC curve is 0.84.

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Score of Bartolucci et al for Predicting the Acute Chest Syndrome During a Sickle Cell Vaso-Occlusive Crisis

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