Wheezing and asthma are independent risk factors for increased sickle cell disease morbidity
Wheezing and asthma are independent risk factors for increased sickle cell disease morbidity
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DOI：
10.1111/bjh.12049
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发表时间：
2012-11-01
影响因子：
6.5
通讯作者：
Richardson, Lynne D.
中科院分区：
文献类型：
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作者：
Glassberg, Jeffrey A.;Chow, Annie;Richardson, Lynne D.
为了评估医生诊断的哮喘和喘息（独立于哮喘诊断）与镰状细胞病（SCD）发病率之间的关系，我们对2007年1月1日至2011年1月1日期间因SCD到西奈山医学中心急诊科（艾德）就诊的患者进行了回顾性分析。结局为艾德因疼痛和急性胸部综合征就诊。该队列包括262名个体，中位年龄为23.8岁（范围：6个月至67.5岁）。18.7%（49/262）的患者在体格检查中至少记录了一次喘息发作。哮喘和喘息并不完全重叠，53.1%的喘息患者没有进行哮喘的诊断。喘息与艾德因疼痛就诊增加118%（95%置信区间[CI]：56-205%）和艾德因急性胸部综合征就诊增加158%（95% CI：11-498%）相关。哮喘的诊断与疼痛的艾德使用增加44%（95%CI：2-104%）相关，而急性胸部综合征的艾德使用没有增加（率比1.00，95%CI 0.41-2.47）。总之，哮喘和喘息是SCD患者疼痛发作增加的独立危险因素。只有喘息与更严重的急性胸部综合征相关。
To assess the associations between a doctor diagnosis of asthma and wheezing (independent of a diagnosis of asthma) with sickle cell disease (SCD) morbidity, we conducted a retrospective review of Emergency Department (ED) visits to the Mount Sinai Medical Center for SCD between 1 January 2007 and 1 January 2011. Outcomes were ED visits for pain and acute chest syndrome. The cohort included 262 individuals, median age 23.8 years, (range: 6 months to 67.5 years). At least one episode of wheezing recorded on a physical examination was present in 18.7% (49 of 262). Asthma and wheezing did not overlap completely, 53.1% of patients with wheezing did not carry a diagnosis of asthma. Wheezing was associated with a 118% increase in ED visits for pain (95% confidence interval [CI]: 56-205%) and a 158% increase in ED visits for acute chest syndrome (95% CI: 11-498%). A diagnosis of asthma was associated with a 44% increase in ED utilization for pain (95% CI: 2-104%) and no increase in ED utilization for acute chest syndrome (rate ratio 1.00, 95%CI 0.41-2.47). In conclusion, asthma and wheezing are independent risk factors for increased painful episodes in individuals with SCD. Only wheezing was associated with more acute chest syndrome.