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214445 Asthma in sickle cell disease as a risk factor for acute chest syndrome in pediatric patients
Wednesday, November 10, 2010 : 10:35 AM - 10:50 AM
OBJECTIVES: Asthma and sickle cell disease (SCD) are major Public Health concerns. Previous studies demonstrated that asthma among children with SCD may increase the risk of developing acute chest syndrome (ACS). These respiratory complications may increase emergency department (ED) utilization, increase health care costs, and reduce life span among persons with SCD. The purpose of this study is to determine whether children with SCD and asthma have significantly more ED visits and if they are at higher risk of developing ACS compared to children with SCD who do not have asthma. METHODS: We used MarketScan® Multi-State Medicaid Databases from Thompson Reuters (Ann Arbor, Michigan) for the years 2001-2005. These are proprietary datasets covering eight unidentified states. We used International Classification of Disease, 9th Division, Clinical Modifications (ICD-9-CM) codes to identify SCD, asthma and ACS. RESULTS: In 2005, 2428 children with SCD enrolled in Medicaid. Among those, 369 (15.2%) patients had asthma. The mean number of ED visits was significantly higher among children with both SCD and asthma compared to children with SCD without asthma (p<0.05). Children with SCD and asthma were also more likely to have at least one episode of ACS than children with SCD without asthma (28.2% vs. 7.8%, respectively). CONCLUSIONS: Among children with SCD who are enrolled in Medicaid, asthma is a common comorbidity, which is associated with high incidence of ACS. Asthma should be aggressively managed among SCD patients, which could result in reduced costs related to ED utilization and reduce pulmonary complications that progress into adulthood lung disease.
Learning Areas:Chronic disease management and prevention
Other professions or practice related to public health
Keywords: Asthma, Pediatrics
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am registered respiratory therapist with adult and pediatric critical care experience, as well as an Adjunct Professor for the Respiratory Therapy Program at the University of the District of Columbia. I am also currently enrolled in a professional masters program in Public Health, which allowed me to participate in an 8-week Summer Internship at the Center for Disease Control and Prevention.
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
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