Analysis of 81 cases of acute chest syndrome in adult patients with sickle-cell disease in Curacao - abstract

ABSTRACT

All patients more than 14 years old with sickle-cell disease (SCD) discharged from hospital with a diagnosis of acute chest syndrome (ACS) from January, 1980 to December, 1981 were enrolled in this retrospective study. Data were collected from patients' records to investigate frequency, risk factors, effect of intravenous heparin and outcome in ACS. There were 109 adult SCD patients of whom 53 (49 per cent) were admitted for 81 episodes of ACS. Hb SS and Hb SC patients were affected equally often. Chest pain was the most frequent presenting symptom (64 per cent) and 91 per cent of patients had pulmonary abnormalities on physical examination, but only 45 per cent had radiological evidence of ACS at diagnosis. Forty-three per cent of sputum cultures grew pathogenic micro-organisms. The overall case-fatality rate was 6 per cent. All 5 non-survivors were female Hb SS patients. Intention-to-treat analysis revealed no benefit of intravenous heparin on outcome (mortality 5 per cent versus 11 per cent in non-heparin-treated patients, p = 0.3), hospital stay (p = 0.7) or duration of hypoxaemia (p = 0.4) (AU)