title: Wheezing and asthma are independent risk factors for increased sickle cell disease morbidity.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. Jeffrey.glassberg@mountsinai.org
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Glassberg
authors.forename: Annie
authors.initials: A
authors.lastname: Chow
authors.forename: Juan
authors.initials: J
authors.lastname: Wisnivesky
authors.forename: Ronald
authors.initials: R
authors.lastname: Hoffman
authors.forename: Michael R
authors.initials: MR
authors.lastname: Debaun
authors.forename: Lynne D
authors.initials: LD
authors.lastname: Richardson
mesh_terms: D056586:Acute Chest Syndrome / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001249:Asthma / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009017:Morbidity; D012135:Respiratory Sounds / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult