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Acute chest syndrome among children hospitalized with vaso-occlusive crisis: A nationwide study in the United States.

Abstract

PURPOSE

Acute chest syndrome (ACS) is a common complication among pediatric inpatients with sickle cell disease and vaso-occlusive crisis (VOC). However, little is known about the factors associated with ACS complication. The present study assessed the epidemiological features of children hospitalized with VOC and ascertained factors associated with ACS complication.

METHODS

Hospital discharge records of patients with VOC aged <20 years were obtained for the years 2003, 2006, 2009, and 2012 from the Kids' Inpatient Database. Data were weighted to estimate the annual hospitalization rates with respect to gender and race/ethnicity in the United States. Multivariable logistic regression was conducted to ascertain factors associated with ACS complication after adjusting for patient and hospital characteristics.

RESULTS

The total annual hospitalizations for VOC increased from 22,511 in 2003 to 24,292 in 2012. Multivariable logistic regression analysis showed that children aged 5-9 years had 2.59 times higher odds of ACS than children aged 15-19 years (95% confidence interval [CI], 2.32-2.88). Comorbidity of asthma (odds ratio [OR], 1.42; 95% CI, 1.31-1.54) and obstructive sleep apnea (OR, 1.70; 95% CI, 1.31-2.20) were associated with ACS development. ACS was also associated with male gender and the summer and fall seasons.

CONCLUSION

We reported nationwide estimates of the annual hospitalization rate for childhood VOC in the United States and demonstrated the major risk factors associated with ACS complication. Vigilance is needed for ACS complications in high-risk VOC admissions.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York.

    ,

    Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California. Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.

    Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts.

    Source

    Pediatric blood & cancer 65:3 2018 03 pg

    MeSH

    Acute Chest Syndrome
    Adolescent
    Anemia, Sickle Cell
    Arterial Occlusive Diseases
    Child
    Child, Preschool
    Female
    Hospitalization
    Humans
    Incidence
    Infant
    Infant, Newborn
    Male
    Risk Factors
    United States
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    29134776

    Citation

    Takahashi, Takuto, et al. "Acute Chest Syndrome Among Children Hospitalized With Vaso-occlusive Crisis: a Nationwide Study in the United States." Pediatric Blood & Cancer, vol. 65, no. 3, 2018.
    Takahashi T, Okubo Y, Handa A. Acute chest syndrome among children hospitalized with vaso-occlusive crisis: A nationwide study in the United States. Pediatr Blood Cancer. 2018;65(3).
    Takahashi, T., Okubo, Y., & Handa, A. (2018). Acute chest syndrome among children hospitalized with vaso-occlusive crisis: A nationwide study in the United States. Pediatric Blood & Cancer, 65(3), doi:10.1002/pbc.26885.
    Takahashi T, Okubo Y, Handa A. Acute Chest Syndrome Among Children Hospitalized With Vaso-occlusive Crisis: a Nationwide Study in the United States. Pediatr Blood Cancer. 2018;65(3) PubMed PMID: 29134776.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Acute chest syndrome among children hospitalized with vaso-occlusive crisis: A nationwide study in the United States. AU - Takahashi,Takuto, AU - Okubo,Yusuke, AU - Handa,Atsuhiko, Y1 - 2017/11/14/ PY - 2017/08/14/received PY - 2017/09/24/revised PY - 2017/10/13/accepted PY - 2017/11/15/pubmed PY - 2019/3/26/medline PY - 2017/11/15/entrez KW - acute chest syndrome KW - epidemiology KW - hospitalization KW - kids’ inpatient database KW - sickle cell disease KW - vaso-occlusive crisis JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 65 IS - 3 N2 - PURPOSE: Acute chest syndrome (ACS) is a common complication among pediatric inpatients with sickle cell disease and vaso-occlusive crisis (VOC). However, little is known about the factors associated with ACS complication. The present study assessed the epidemiological features of children hospitalized with VOC and ascertained factors associated with ACS complication. METHODS: Hospital discharge records of patients with VOC aged <20 years were obtained for the years 2003, 2006, 2009, and 2012 from the Kids' Inpatient Database. Data were weighted to estimate the annual hospitalization rates with respect to gender and race/ethnicity in the United States. Multivariable logistic regression was conducted to ascertain factors associated with ACS complication after adjusting for patient and hospital characteristics. RESULTS: The total annual hospitalizations for VOC increased from 22,511 in 2003 to 24,292 in 2012. Multivariable logistic regression analysis showed that children aged 5-9 years had 2.59 times higher odds of ACS than children aged 15-19 years (95% confidence interval [CI], 2.32-2.88). Comorbidity of asthma (odds ratio [OR], 1.42; 95% CI, 1.31-1.54) and obstructive sleep apnea (OR, 1.70; 95% CI, 1.31-2.20) were associated with ACS development. ACS was also associated with male gender and the summer and fall seasons. CONCLUSION: We reported nationwide estimates of the annual hospitalization rate for childhood VOC in the United States and demonstrated the major risk factors associated with ACS complication. Vigilance is needed for ACS complications in high-risk VOC admissions. SN - 1545-5017 UR - https://www.unboundmedicine.com/medline/citation/29134776/Acute_chest_syndrome_among_children_hospitalized_with_vaso_occlusive_crisis:_A_nationwide_study_in_the_United_States_ L2 - https://doi.org/10.1002/pbc.26885 DB - PRIME DP - Unbound Medicine ER -