Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Which Febrile Children With Sickle Cell Disease Need a Chest X-Ray?
source: Academic Emergency Medicine
year: 2016
authors: Eisenbrown K, Nimmer M, Ellison AM, Simpson P, Brousseau DC
summary/abstract:OBJECTIVE:
Controversy exists regarding which febrile children with sickle cell disease (SCD) should receive a chest x-ray (CXR). Our goal is to provide data informing the decision of which febrile children with SCD presenting to the emergency department (ED) require a CXR to evaluate for acute chest syndrome (ACS).
METHODS:
Retrospective chart review of children ages 3 months to 21 years with SCD presenting to the ED at one of two academic children’s hospitals with fever >=38.5°C between January 1, 2010, and December 31, 2012. Demographic characteristics, respiratory symptoms, and laboratory results were abstracted. The primary outcome was the presence of ACS. Binary recursive partitioning was performed to determine predictive factors for a diagnosis of ACS.
RESULTS:
A total of 185 (10%) of 1,837 febrile ED visits met ACS criteria. The current National Heart, Lung, and Blood Institute (NHLBI) consensus criteria for obtaining a CXR (shortness of breath, tachypnea, cough, or rales) identified 158 (85%) of ACS cases, while avoiding 825 CXRs. Obtaining a CXR in children with NHLBI criteria or chest pain and in children without those symptoms but with a white blood cell (WBC) count >=18.75 × 109 /L or a history of ACS identified 181 (98%), while avoiding 430 CXRs.
CONCLUSION:
Children with SCD presenting to the ED with fever and shortness of breath, tachypnea, cough, rales, or chest pain should receive a CXR due to high ACS rates. A higher WBC count or history of ACS in a child without one of those symptoms may suggest the need for a CXR. Prospective validation of these criteria is needed.
DOI: 10.1111/acem.13048
read more full text
Related Content
-
Does sickle cell disease increase risk of adverse outcomes following total hip and knee arthroplasty? A nationwide d...Sickle cell disease (SCD) is associated ...
-
Interim assessment of liver damage in patients with sickle cell disease using new non-invasive techniquesWe explored transient elastography (TE) ...
-
Cognitive Function may be Affected in Adults With Sickle Cell Disease, Study SuggestsAdults with sickle cell disease score wo...
-
Randomized Trials Needed to Assess Benefits of Salmonella Vaccines in SCD Patients, Study SaysRandomized controlled trials are needed ...
-
Only 21% of Kids with ADHD and SCD Are Treated for Attention DeficitA study of children with sickle cell dis...
-
GBT expands sickle cell disease pipeline with worldwide licensing agreement for inclacumab for the treatment of vaso...Global Blood Therapeutics, Inc...
-
Hydroxyurea linked to ‘significant, rapid’ reduction of sperm countSix months of hydroxyurea therapy detrim...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.