Associated Factors of Acute Chest Syndrome in Children with Sickle Cell Disease in French Guiana

Abstract

A matched case-control study was performed in order to identify some associated factors for ACS or to confirm the published data. Controls were children hospitalized during the same period for pain crisis who did not develop an ACS during hospitalization. Between January 2006 and October 2010, there were 24 episodes of ACS distributed among 19 patients (8 girls and 11 boys). The median age was 7.5 years (range: 3 to 17 years) for the cases and 7 years (range: 3–18 years) for the controls. Four cases and 11 controls were treated with hydroxyurea (HU). In 75% of the cases, the ACS had arisen 24–72 hours following admission. The independent factors associated with ACS were average Hb rate <8 g/dL (OR = 4.96, 95% CI = 1.29–27.34, and P = 0.04), annual number of hospitalizations >3 (OR = 5.44, 95% CI = 3.59–8.21, and P = 0.003), average length of hospitalization >7 days (OR = 3.69, 95% CI = 3.59–8.21, and P = 0.003), and a pathological transthoracic echocardiography (TTE) (OR = 13.77, 95% CI = 2.07–91.46, and P = 0.003). Although the retrospective design and small sample size are weaknesses of the present study, these results are consistent with those of previous studies and allowed identifying associated factors such as a pathological TTE.