Outcome Of Crisis Research Articles

Re-examining mental health crisis intervention: A rapid review comparing outcomes across police, co-responder and non-police models.

Police are the default first responders in most mental health crisis intervention models worldwide, resulting in a heavy burden on police, perceived criminalization of individuals with complex mental health needs, and escalation of aggression that resort to violence. Models, such as crisis intervention teams (CIT), and co-response programmes aim to improve service user experiences and outcomes by providing mental health training to police, or pairing law enforcement officers with mental health clinicians, respectively. Despite these efforts, mental health-related calls continue to result in negative outcomes, and activists and policymakers are advocating for non-police models of crisis intervention. Evidence-based practice in mental health crisis intervention is urgently needed. The present review's main objective was to examine, synthesise and compare outcomes across police, co-responder and non-police models of mental health crisis intervention internationally using a rapid review framework. A systematic search of four electronic databases of studies published between 2010-2020 and a grey literature search was conducted, yielding (n=1008) articles. A total of 62 articles were included in the present review. Studies were largely observational, lacking control groups and were of low-moderate quality with a high potential for bias. Overall, there is little evidence to suggest that the CIT model impacts crisis outcomes. Co-responder models evidenced improved outcomes compared to police only models, however, evidence was often mixed. Non-police models varied significantly, and studies tended to be too low quality to make comparisons or draw conclusions, however, research on youth models and crisis resolution home treatment suggested positive outcomes. Findings highlight the need for high-quality studies and policies to facilitate the implementation and evaluation of novel approaches not involving police. Cross-sectorial collaboration and service user input are urgently needed to inform, develop, test and disseminate effective models of crisis intervention acceptable to service users.

Community-Led Provision of Nonformal Education for Displaced Learners in Northern Nigeria

In this field note, I explore the community coalition model Creative Associates International and its partners employed to provide nonformal education to out-of-school displaced children and youth in northern Nigeria under the USAID-funded Education Crisis Response project. While there is no evidence directly linking community involvement to improved education outcomes in crisis- and conflict-affected contexts, the existing literature and final project results point to its importance in the education in emergencies field. In this field note, I briefly shed light on the education landscape in northern Nigeria, offer global evidence on the impact of community participation in education in low-income and crisis- and conflict-affected contexts, and describe the promise a community-led model employed by the Education Crisis Response project holds for improving education access for out-of-school internally displaced children and youth. I also describe the community mobilization and capacity-building approach adopted for the project and its success in providing access to education for more than 80,000 learners in a volatile region.

Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

Background: A hypertensive crisis may manifest as hypertensive emergency or urgency. Hypertensive emergency is characterized by target organ damage and poses immediate threat to life, a situation not seen in urgency. Aims and Objectives: The aims of the study were as follows: (1) To determine the prevalence of hypertensive crisis classified as emergency, urgency, and pseudocrisis. (2) To assess the various systems (neurological, cardiovascular, and renal) affected in relation to a particular type of hypertensive crisis. Materials and Methods: The retrospective study comprised analysis of medical records of 100 patients of hypertensive crisis admitted to emergency unit of BPS Government Medical College and Hospital for Women, Sonepat, Haryana, India, in the 2 years period from January 2018 to December 2019 and study their prevalence among hospital emergencies and clinical presentation. Results: Total number of clinical emergencies analyzed during this time interval was 6666. The prevalence of hypertensive crisis accounted to 1.5% of all the clinical emergencies received. About 66% presented as hypertensive emergencies, 32% as hypertensive urgency, and 2% presented as hypertensive pseudocrisis. Males of the fifth decade of life while females of the sixth decade of life were most affected by hypertensive crisis. Headache (58%) followed by giddiness (44%) was the most common clinical presentation in the emergency. About 34% of patients had associated neurological deficit. Only 16% of patients had cardiovascular system involvement. Conclusion: Symptoms provided by patients in the emergency department are of paramount importance for the outcome of hypertensive crisis. Severe complication of hypertensive crisis can be prevented if hypertension is timely diagnosed and appropriately managed.

Nano dimensions/adjuvants in COVID-19 vaccines.

A favorable outcome of the COVID-19 crisis might be achieved with massive vaccination. The proposed vaccines contain several different vaccine active principles (VAP), such as inactivated virus, antigen, mRNA, and DNA, which are associated with either standard adjuvants or nanomaterials (NM) such as liposomes in Moderna's and BioNTech/Pfizer's vaccines. COVID-19 vaccine adjuvants may be chosen among liposomes or other types of NM composed for example of graphene oxide, carbon nanotubes, micelles, exosomes, membrane vesicles, polymers, or metallic NM, taking inspiration from cancer nano-vaccines, whose adjuvants may share some of their properties with those of viral vaccines. The mechanisms of action of nano-adjuvants are based on the facilitation by NM of targeting certain regions of immune interest such as the mucus, lymph nodes, and zones of infection or blood irrigation, the possible modulation of the type of attachment of the VAP to NM, in particular VAP positioning on the NM external surface to favor VAP presentation to antigen presenting cells (APC) or VAP encapsulation within NM to prevent VAP degradation, and the possibility to adjust the nature of the immune response by tuning the physico-chemical properties of NM such as their size, surface charge, or composition. The use of NM as adjuvants or the presence of nano-dimensions in COVID-19 vaccines does not only have the potential to improve the vaccine benefit/risk ratio, but also to reduce the dose of vaccine necessary to reach full efficacy. It could therefore ease the overall spread of COVID-19 vaccines within a sufficiently large portion of the world population to exit the current crisis.

Resilience to crisis and resistance to change: a comparative analysis of the determinants of crisis outcomes in Latin American regional organisations

Latin American regionalism displays a long history of crises, which have affected almost all regional organisations (ROs) across different waves of regionalism. The article conducts the first comparative analysis of the outcomes of crises in Latin American ROs across time, tackling the following questions: What have been the outcomes of the crises faced by Latin American ROs? Under what conditions does a crisis result in the survival or breakdown of the affected RO in Latin America? We adopt a multi-method approach that combines QCA with process tracing to identify the causal pathways to the survival or breakdown of ROs across a universe of eight crises. The findings show that Latin American ROs have been resilient to crises, which resulted in RO survival in seven cases out of eight. The QCA reveals how the distributive nature of interstate conflicts and the availability of majority voting are both sufficient conditions for Latin American ROs to survive a crisis. Analysis of the outlier case of UNASUR shows that normative conflicts that take place in the absence of majority voting constitute a ‘perfect storm’ configuration that can lead to RO breakdown. The findings also show that Latin America ROs’ tendency to survive crises is associated with the preservation of the status quo in terms of institutional design, which in some cases is achieved through the temporary flexibilisation of existing rules. Differently from the case of the EU, then, the crises of Latin American ROs have not led to the deepening of regional integration, but rather to institutional inertia.

Abstract 10026: Higher Odds of Major Adverse Cardiovascular and Cerebrovascular Events in Hospitalized Cancer Patients with Hypertensive Crisis: A Nationwide Population-Based Study

Background: Cancer patients have an increased risk of new-onset hypertension. Burden, comorbidities, and outcomes of hypertensive crisis (HTNcrisis) in prior and current cancer patients remain undefined. Methods: The National Inpatient Sample (2015 October-2017) was used to identify cancer patients (current+prior cancer) and sub-grouped into HTNcrisis vs. non-HTNcrisis to compare demographics, comorbidities, and outcomes (MACCE-major adverse cardiovascular and cerebrovascular events: all-cause mortality, acute myocardial infarction, cardiac arrest & stroke). Results: Active or prior cancer diagnosis had 9,279,536 admissions, of which 70,530 had HTNcrisis (0.8%). HTNcrisis arm more often included older (74 vs. 71 years), black (22.5 vs. 11.0%), female (58.5% vs. 50.7%), Medicare enrollees (77.2% vs. 67.9%) vs. non-HTNcrisis (Table 1) . HTNcrisis arm had higher rates of hyperlipidemia, smoking, diabetes, renal failure, CHF, prior TIA/stroke, prior CABG vs non-HTNcrisis. Cancer with HTNcrisis had higher rate and odds of MACCE (9.7% vs.19.6%, OR:1.92, 95CI:1.88-1.96), higher rate of AMI (7.6% vs 3.3%), arrhythmia (29.8% vs 27.2%), stroke (10.8% vs 3.0%) with comparable healthcare resource utilization (p<0.001). Of the HTNcrisis cohort, patients with an active cancer diagnosis with prior history of treated cancer (4.9%) had higher all-cause mortality compared to patients with either currently active cancer (4.0%) or prior cancer (2.1%) (p<0.001). Conclusion: Cancer patients with HTNcrisis often included elderly, black, and female compared to those without. HTNcrisis admissions had two times higher odds of MACCE including higher rates of AMI, arrhythmia and stroke. Among HTNcrisis admissions, patients currently diagnosed with active cancer along with prior history experienced a higher burden of inpatient deaths compared to admissions either with current or prior cancer.

Relation of Type 2 Myocardial Infarction and Readmission With Type 1 Myocardial Infarction in Hypertensive Crises (from a Nationwide Analysis)

Type 2 myocardial infarction (T2MI) is an ischemic injury that occurs due to a mismatch between myocardial oxygen supply and demand. T2MI can occur with hypertensive crisis. Nevertheless, the impact of T2MI on hypertensive crisis outcome is poorly understood due to limited data. This study was a retrospective analysis of the National Readmission Database year 2018. Patients were included if the primary diagnosis was hypertensive crisis, hypertensive urgency, or hypertensive emergency. Patients were excluded if they had type 1 myocardial infarction (T1MI), severe sepsis, septic shock, gastrointestinal bleeding, or hemorrhagic anemia at index admission. The primary outcome was 90-day readmission with T1MI. Secondary outcomes were in-hospital mortality, length of stay, resource utilization, and all-cause 90-day readmission. Subgroup analysis was done according to urgency and emergency presentation. A total of 101,211 index hospitalizations were included in our cohort, of whom 3,644 (3.6%) received a diagnosis of T2MI. A total of 912 patients were readmitted within 90 days with T1MI. T2MI was an independent predictor of 90-day readmission with T1MI (adjusted odds ratio [aOR] 2.64, 95% confidence interval [CI] 1.90 to 3.66, p <0.01). Subgroup analysis including only hypertensive urgency and hypertensive emergency yielded similar results (aOR 2.80, 95% CI 1.56 to 5.01, p <0.01 and aOR 2.28, 95% CI 1.59 to 3.27, p <0.01, respectively). In conclusion, T2MI was an independent predictor of poor outcome in patients presenting with hypertensive crisis. Further studies are needed to guide the management of T2MI in this population.

To Blame is Human: A Quantitative Systematic Review of the Relationship Between Outcome Severity of Large-Scale Crises and Attributions of Blame.

In crisis situations, time is of the essence. Effective messaging to individuals at risk is critical to mitigating the most severe outcomes. Extant crisis communication literature has focused on differentiating crisis types based on perceived blame, particularly in cases of for-profit company malfeasance, but less work has been done to understand how the public makes these types of attributions. This quantitative systematic review investigates the relationship between severity of a large-scale crisis outcome and attributions of blame toward relevant entities. Moderators of interest include the attribution term used with participants (e.g., blame, responsibility), the type of crisis event, and the entity presented as at fault. Overall, a small but significant positive relationship is identified in the majority of studies between severity of a large-scale crisis outcome and attributions of blame. Results suggest that while crisis type and entity to blame are moderators, the attribution term(s) used with participants plays a less significant role. Implications and future directions are considered.

Estimating redenomination risk under Gumbel–Hougaard survival copulas

We study the dependence between redenomination and default risk for Italy, France, Germany and the Netherlands exploiting the 2014 revision of ISDA CDS contract standard. For these countries redenomination has become a credit event under the new standard, while it was not so under the old standard. Both contracts are currently traded. Using MLE on transformed data we simultaneously estimate the dependence of the two risks and an unbiased measure of redenomination risk. The unbiased estimate unveils a feature common to all four countries. Redenomination risk has risen and remained above default risk since February 2017, when the U.K. Parliament officially approved the formal request to start the Brexit procedure. We find that after February 2017 the CDS market has mostly priced redenomination as the most likely outcome of the next sovereign crisis in the Euro area. Finally, we use a Marshall–Olkin approach to model the dependence of redenomation risk of the countries and to estimate a measure of the end of the Euro. The measure obtained is very close to the value of the German CDS, in support of the widespread market practice of using that contract as tail-hedge against end of the Euro.

Public expectations of crisis outcomes in the social media era in China: A communication-mediated psychological mechanism

This study theoretically and empirically identifies a new typology of Chinese publics’ normative expectations of crisis outcomes. It classifies the concept into three culturally relevant dimensions—public expectations of (a) organizational accommodative responses (i.e., how an in-crisis organization should respond), (b) punishment of the organization (i.e., how publics collectively should respond), and (c) government intervention (i.e., how government should respond) for desirable crisis outcomes. Using an online survey of the Beijing public, this study investigates the degree to which information seeking and online expression mediate relationships between crisis blame and the three types of expectations. The study finds that as the level of crisis blame increases, active information seekers expect more regarding organizational accommodation and government intervention, whereas active expressers expect stronger punishments of the organization and less government intervention in China.

Are unsuccessful entrepreneurial experiences harmful?: Product failures in medical device ventures

Entrepreneurial processes are learning journeys; as entrepreneurs found one company after another, they learn from those experiences to create better-performing companies. Compared with this widely documented learning effect, knowledge on debilitating behavioral consequences of entrepreneurial processes, especially involving unsuccessful entrepreneurial experiences (UEEs), remains limited. By drawing on behavioral decision theories, we argue that UEEs can lead to entrepreneurs’ increased desperation to succeed and higher tolerance for risk, which in turn may result in the dysfunctional outcome of product-harm crises in their subsequent ventures. We further argue that desperation effects may be stronger when the venture is founded by a solo entrepreneur or during an economic recession. On the other hand, the positive effect of higher risk tolerance on product-harm crises is argued to be less pronounced when the penalty against risk taking is high, such as when the venture has several product lines and one product-harm crisis can have a spillover effect on other products, or when the venture faces stricter regulations for product functionality, quality, and safety. An analysis of new ventures in the U.S. medical device industry provides an overall support for our claims.

Modeling and Simulating Cross Country Banking Contagion Risks

The recent financial crisis proved that financial contagion could spread among countries resulting in disruptive effects. In this paper, by modeling and simulating banking system behavior and linkages across countries, we assess, based on data from the BIS and IMF, the possible outcome of domestic crises and how contagion spreads over countries. Results allow detailing the role of a “lighter” or of a “fueler” of financial crises for each country and assessing how each country can affect each other country by contagion, signaling the importance of financial interdependence between some neighboring countries, and detailing which counterpart country would be affected by the ring-fencing of each considered country’s banking system. The method also allows for what-if analyses to optimize the risk exposures, and to plan an emergency strategy in case of alarms coming from specific countries.

Financial distress and suicidal behaviour during COVID-19: Family identification attenuates the negative relationship between COVID-related financial distress and mental Ill-health.

COVID-19 provides a ‘perfect storm’ of social and economic suicide risk-factors. Recent research has evidenced an initial impact of the pandemic upon suicide rates, but has yet to understand how elevated financial threat and social isolation may predict suicide ideation/behaviour, or which social factors promote resilience. This study addressed these shortcomings. An online longitudinal survey study (N = 370) which took place from May to September 2020 showed COVID-related financial distress predicts suicidal thoughts and behaviour via increased depression and loneliness. Family identification attenuates these relationships. Our findings reaffirm the importance of social factors in reducing mental ill-health outcomes of economic crises.

Measuring risks and vulnerability of tourism to the COVID-19 crisis in the context of extreme uncertainty: The case of the Balearic Islands

The COVID-19 crisis is dramatically affecting the world economy and, particularly, the tourism sector. In the context of extreme uncertainty, the use of probabilistic forecasting models is especially suitable. We use Monte Carlo simulations to evaluate the outcomes of four possible tourism demand recovery scenarios in the Balearic Islands, which are further used to measure the risks and vulnerability of Balearic economy to the COVID-19 crisis. Our results show that fear of contagion and loss of income in tourism emitting countries will result in a maximum 89% drop in arrivals in the Balearic Islands in 2020.Given that most tourism-related occupations are not highly skilled and are characterized by lower salaries, there are greater risks of loss of welfare, especially for women, who are a major share of the tourism labour force.The model shows important differences among minimum, average and maximum estimates for tourism sector production in 2021, reflecting considerable uncertainty regarding the speed of the sector's recovery. The results serve as a basis to prepare a range of policies to reduce destination vulnerability under different crisis outcomes.

The outcomes of COVID-19 epidemic crisis on the elderly: A review study

Background: Coronavirus disease 2019 (Covid-19) has led to more than 111,973,202 confirmed cases, and more than 2,478,409 deaths worldwide. Mortality rates are significantly higher in the elderly than in others during the epidemic of COVID-19; age is significant vulnerabilities to COVID-19. Analysis of clinical features according to the latest published data allows better understanding and better clinical judgment. Methods: In this review study, using the keywords, COVID-19, severe acute respiratory syndrome coronavirus (SARS-CoV-2), coronavirus, viral and elderly pneumonia, pandemic, epidemic, quarantine, mental health, and social isolation in articles indexed in Embase, Proquest, Pub med, Google Scholar, Science direct, Scopus, Medline, Cochrane databases from December 2019 to February 2020, were searched. Findings: The elderly of more than 65-year-old are classified in high-risk groups, are more vulnerable than other age groups, and require more attention. Social isolation, social distance, and lockdown has raised concerns about their mental health to prevent the spread of COVID-19. Conclusion: Due to the increasing population of the elderly, such biological disasters, if do not take care of and pay enough attention to the various dimensions and problems caused by its consequences, would affect acute and long-term consequences on community health and general health of the elderly. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.

Outcome of Severe Vaso Occlusive Crisis in Sickle Cell Disease Adults Admitted to Referral Centers in Africa and Europe. Preliminary Results from the Presev 2 Study

▪Introduction : Vaso-Occlusive Crisis (VOC), the most common manifestation of sickle cell disease (SCD), is the first cause of death, particularly when complicated by an acute chest syndrome (ACS).In the PRESEV1 study, we developed a predictive score of secondary ACS in SCD patient admitted in the hospital for VOC (AUC = 0.840 [95% CI: 0.780 - 0.900]), with a negative predictive value of 98.8% for the low level risk and a positive predictive value of 39.5%. The aim of the PRESEV-2 study is to validate the predictive score of ACS on adults and children with SCD in Europe and Africa. Herein we present preliminary data on 235 adults with a severe VOC included in 11 referral centers from 4 countries.Patients and Methods: We conduct an international multicenter prospective observational study. The primary outcome measure is the occurrence of an ACS. The ACS is defined as a new auscultatory abnormality (crepitation or bronchial breathing) OR the association of a new radiologic infiltrate AND chest pain or decreased breath sounds. Secondary outcome measures are length of hospitalization, transfusion, morphine consumption, mortality and hospitalization in intensive care unit. Inclusion criteria are: SS or S-b0 thalassemia patients, VOC admitted at the emergency unit (VOC is defined as pain or tenderness affecting at least one part of the body not attributable to other causes) that required hospitalization and opioids (level 3). Exclusion criteria are: no inaugural ACS, homeless patients, pregnancy, deprived of their liberty or under guardianship, unable to understand the purpose and conditions of carrying out the study, unable to give consent.Results : From march 2016 to june 2017, 112 adult patients were included in Africa and 122 adults in Europe. Patients in Africa were younger than in Europe with a mean age, respectively, of 26 ± 7 yrs and 29 ± 8 yrs (p=0.008). Sex ratio (M/F) in Africa was 0.84 and 0.95 in Europe. Use of hydroxyurea was significantly higher in Europe (65%) than in Africa (6%) (p<0.0001). The ACS incidence was significantly higher in Africa than in Europe, respectively 22% and 11% (OR=2.24; p=0.03), in both areas the time for ACS appearance was the second day. Transfusion was performed in 27% in Africa and 6% in Europe (p<0.001), ACS was the main cause of transfusion (53.3% in Africa and 62.5% in Europe). Patients with ACS were more transfused in Africa than in Europe, respectively 64% and 35.7% but the difference was not significant. Mortality was 3.6% in Africa and was not observed in Europe; circumstances of death were stroke (1), profound anemia (1), kidney failure (1) and VOC (1).Discussion and conclusion: Our preliminary results provide epidemiologic insights about VOC and ACS incidence in Europe and Africa. A better availability of HU treatment in Africa is a health care priority. DisclosuresGalactéros:Addmedica: Membership on an entity's Board of Directors or advisory committees. Bartolucci:GBT: Membership on an entity's Board of Directors or advisory committees; Fondation Fabre: Research Funding; Addmedica: Research Funding; Novartis US: Membership on an entity's Board of Directors or advisory committees.

Violence and abuse experiences and associated risk factors during the COVID-19 outbreak in a population-based sample of Norwegian adolescents

BackgroundThe lockdowns occurring across society because of the COVID-19 pandemic have had far-reaching consequences for children and adolescents. One immediate concern was what the impact of the comprehensive disease control measures on rates of violence and abuse against children and adolescents would be. ObjectiveWe aimed to establish rates of child abuse and degree of family conflict during the first COVID-19 lockdown spring 2020. Additionally, we aimed to investigate associations between preexisting and concurrent risk factors and abuse during these unique times. Participants and settingA total of 3545 Norwegian 13- to 16-year-olds participated in this study. A total of 1944 of these had provided data 1 year before the lockdown. MethodsWe used a web survey format to assess abuse exposure and associated risk factors. The survey was administered in schools during school hours in June 2020, shortly after the reopening of schools after the first lockdown. ResultsIn this sample 8.2% reported psychological abuse during lockdown, 2.4% had experienced physical abuse and 1.4% sexual abuse. For online sexual abuse, the rate was 5.6% during this time period. Adolescents did not report an increase in family conflict. Concurrently perceived family affluence and family risk factors were most strongly associated with physical abuse during lockdown (OR = 11.01(95% CI 5.32–22.84); OR = 5.36 (95% CI 2.69–10.67)), but also other types of child maltreatment. Analyses across assessment points suggested that prior victimization was the most accurate predictor of abuse experiences during lockdown (OR = 3.84 (95% CI 2.85–5.20)). ConclusionsThe negative consequences of the COVID-19 preventative measures struck the adolescent population unevenly. The findings underscore the need for targeted measures to mitigate the negative outcomes of health-related crises for adolescents in risk groups such as those with low family affluence and prior abuse experiences.

How societal expectations, new digital tools, andthe COVID crisis are driving a step-change in human centric remediation.

How societal expectations, new digital tools, andthe COVID crisis are driving a step-change in human centric remediation.

Decision-Making in U.S. Foreign Policy Crises: Presidential Leadership and Outcomes

Scholars of foreign policy decision-making have argued that international interactions ultimately are grounded in people acting singly or in groups. Unfortunately, data limitations prevent many of these crucial foreign policy decision-making theories from being rigorously tested and systematically compared with theories from alternative perspectives. A promising approach to remedying this deficiency is the addition of decision-making variables to existing, large- N data sets. In this study, we coded a series of foreign policy decision-making variables for all U.S. cases in the International Crisis Behavior (ICB) data set, and examined how these decision-making variables compared with structural factors in shaping crisis outcomes. The results reveal that when controlling for structural factors such as conflict setting and power discrepancy, foreign policy decision-making variables related to leaders’ traits, advisory structure, and the political context shaped the severity and centrality of violence employed by the United States. We conclude that including decision-making variables alongside structural variables will enhance the quality of data analysis in the areas of conflict studies and foreign policy analysis.

551 Outcomes of Sickle Cell Crisis in Relation to Pediatric Obstructive Sleep Apnea in the United States: A US Population cohort study

Abstract Introduction This study aimed to quantify the impact of obstructive sleep apnea (OSA) on the mortality, morbidity, and resources utilization among children admitted with Sickle cell crisis (SCC) Methods This is a retrospective analysis using the 2016 and 2017 National Inpatient Sample Database. The Inclusion Criteria was a principal Diagnosis of SSC and age &amp;lt;18 years. OSA, as a Secondary Diagnosis, was identified using the appropriate ICD-10 CM codes. The Primary Outcomes were Inpatient Mortality, and secondary outcomes were: In-Hospital Length of Stay(LOS), Total hospitalization Cost, Blood transfusion (BT) requirement, and a requirement for Invasive mechanical ventilation (IMV). We used Multivariate Linear/ logistic regression to adjust for confounders including age and sex. Results Out of 36,484 children with SSC included in the study, 1450 children had OSA (SCC+OSA). SSC-OSA and SSC+OSA groups did not differ in gender, household income, and hospital characteristics, but did so in age (11.3 vs 12.4; p &amp;lt;0.001). OSA was most common in the age group of 13–18 (54%) and lowest in 0–4 (2.4%). Compared to SSC-OSA, the SCC+OSA cohort had significantly higher odds of mortality (adjusted OR= 11.9, [95% Confidence Interval: 1.02- 138.8],p=0.04). Additionally, SSC+OSA cohort was associated with increased odds of IMV (aOR=5.24 [CI: 1.84 – 14.8], p=0.002), longer LOS (adjusted mean difference (aMD)=0.67 [CI-0.32 – 1.02], p=&amp;lt;0.001), and higher hospitalization Cost (aMD=2818.76 [CI-1680- 4157], p=&amp;lt;0.001). No difference in BT (aOR=0.94 [CI: 0.68 – 1.29], p=0.71) was noted. Conclusion This study demonstrates that the presence of OSA is associated with detrimental outcomes in SSC with higher in-hospital mortality, higher morbidity (Invasive mechanical ventilation rate), and higher resource utilization (LOS, total hospitalization cost). More attention to the screening, early diagnosis, and appropriate treatment of OSA is imperative to improve health outcomes in children with sickle cell disease. Support (if any):