Skip to main content
Journal cover image

Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease.

Publication ,  Journal Article
Strouse, JJ; Takemoto, CM; Keefer, JR; Kato, GJ; Casella, JF
Published in: Pediatr Blood Cancer
May 2008

BACKGROUND: Acute chest syndrome (ACS) is a frequent cause of hospitalization and mortality in children with sickle cell disease. Transfusion is often required to prevent respiratory failure and treatment with dexamethasone may reduce the length of admission and the need for transfusions. We performed a retrospective cohort study to evaluate risk factors for readmission and prolonged hospitalization after different treatments for ACS. PROCEDURE: We identified patients <22 years of age hospitalized with ACS at Johns Hopkins Hospital from January 1998 to April 2004 using the hospitals discharge database and by reviewing dictated summaries. RESULTS: We identified 65 patients with 129 episodes of ACS (mean age 12.5 years, range 1.2-21.9 years). Thirty-nine episodes were treated with corticosteroids and 51 with transfusions. Patients were readmitted within 14 days after 23 episodes (18%). Readmission was strongly associated with report of an inhaler or nebulizer at home [odds ratio (OR) 6.0, P < 0.05], diastolic BP at 48 hr (OR 1.8 per 10 mm increase, P<0.01), corticosteroids (OR 20, P < 0.005), or transfusion (OR 0.03, P < 0.05). Treatment with corticosteroids alone (P < 0.05) and older age (P < 0.001) were associated with longer hospitalization. CONCLUSIONS: These results demonstrate a greatly elevated independent risk of readmission after ACS in children with asthma and after treatment with corticosteroids and a protective effect of transfusion. Although dexamethasone has documented efficacy for reducing the duration of ACS, the substantial risk of readmission for pain should limit its use.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatr Blood Cancer

DOI

EISSN

1545-5017

Publication Date

May 2008

Volume

50

Issue

5

Start / End Page

1006 / 1012

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Syndrome
  • Survival Rate
  • Retrospective Studies
  • Respiration Disorders
  • Prednisone
  • Prednisolone
  • Patient Readmission
  • Oncology & Carcinogenesis
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Strouse, J. J., Takemoto, C. M., Keefer, J. R., Kato, G. J., & Casella, J. F. (2008). Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease. Pediatr Blood Cancer, 50(5), 1006–1012. https://doi.org/10.1002/pbc.21336
Strouse, John J., Clifford M. Takemoto, Jeffrey R. Keefer, Gregory J. Kato, and James F. Casella. “Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease.Pediatr Blood Cancer 50, no. 5 (May 2008): 1006–12. https://doi.org/10.1002/pbc.21336.
Strouse JJ, Takemoto CM, Keefer JR, Kato GJ, Casella JF. Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease. Pediatr Blood Cancer. 2008 May;50(5):1006–12.
Strouse, John J., et al. “Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease.Pediatr Blood Cancer, vol. 50, no. 5, May 2008, pp. 1006–12. Pubmed, doi:10.1002/pbc.21336.
Strouse JJ, Takemoto CM, Keefer JR, Kato GJ, Casella JF. Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease. Pediatr Blood Cancer. 2008 May;50(5):1006–1012.
Journal cover image

Published In

Pediatr Blood Cancer

DOI

EISSN

1545-5017

Publication Date

May 2008

Volume

50

Issue

5

Start / End Page

1006 / 1012

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Syndrome
  • Survival Rate
  • Retrospective Studies
  • Respiration Disorders
  • Prednisone
  • Prednisolone
  • Patient Readmission
  • Oncology & Carcinogenesis
  • Male