Mortality Asthma Smoking and Acute Chest Syndrom

Authors: Jennifer M KnightMadden Antoinette BartonGooden Steve R Weaver Marvin Reid Anne Greenough

Publish Date: 2012/11/13

Volume: 191, Issue: 1, Pages: 95-100

PDF Link

Abstract

Sickle cell disease SCD patients with asthma have an increased risk of death Acute chest syndrome ACS is a major cause of mortality in patients with SCD and ACS may be more common in SCD patients who smoke The purpose of this study was to test the hypothesis that mortality in young adults with SCD would be greater than that of controls during a 10year period and to determine whether asthma reduced lung function ACS episodes and/or smoking predicted mortality during the followup periodThe outcomes during a 10year period were ascertained of SCD patients and racematched controls who had taken part in a pulmonary function study when they were between age 19 and 27 years Smoking and asthma status and whether they had had ACS episodes were determined and lung function was measured at the initial assessmentSeventyfive subjects with SCD were followed for 683 patient years There were 11 deaths with a mortality rate of 16 deaths per 100 patient years which was higher than that of the controls one death in 47 controls was observed for 469 patient years with a mortality rate of 02 per 100 patient years p = 003 There were no significant associations of body mass index recurrent episodes of acute chest steady state haemoglobin or gender with mortality Adjusting for baseline lung function in SCD patients “current” asthma hazard ratio HR 112 95  confidence interval CI 25–506 p = 0002 and smoking HR 27 95  CI 13–55 p = 0006 were significantly associated with mortality during the 10year periodWe acknowledge the contribution to this work of Miss Norma Lewis Research Nurse who died before the project was completed We acknowledge the Caribbean Health Research Council and The Principal Mona Campus University of the West Indies who funded this work Dr KnightMadden was supported by an MRC Fellowship and the followup study was supported by the Caribbean Health Research Council and a New Initiative Grant University of the West Indies

Keywords: