A number of clinical findings may increase the risk that a patient with sickle cell disease will develop the acute chest syndrome. A patient at high risk may benefit from more aggressive monitoring and management.
Risk factors for the acute chest syndrome:
(1) homozygous SS or heterozgyous S with beta-0 thalassemia
(2) child (risk is highest in children 2-4 years of age, then gradually decreases as the patient gets older)
(3) no or mild anemia
(4) low levels of fetal hemoglobin F
(5) elevated steady state white blood cell count
(6) after major surgery
(7) failure to use the pneumococcal, hemophilus and influenza vaccines
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