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Score of Bartolucci et al for Predicting Acute Chest Syndrome During a Vaso-Occlusive Crisis in a Sickle Cell Patient

Description

Bartolucci et al developed a score for predicting the risk for the acute chest syndrome in a patient with sickle cell disease who is experiencing a vaso-occlusive crisis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Henri Mondor Hospital in Creteil, France.


 

Patient selection: sickle cell disease with vaso-occlusive crisis

 

Outcome: acute chest syndrome (ACS)

 

Parameters from Day 1:

(1) reticulocyte count in 10^9/L

(2) categorical pain scale in spine and/or pelvis

(3) white blood cell (WBC) count in 10^9/L

(4) hemoglobin in g/dL

Parameter

Finding

Points

reticulocyte count

<= 216

0

 

> 216

6

pain in spine and/or pelvis

0 or 1 (no or mild pain)

0

 

2 (moderate pain)

4

 

3 (severe pain)

6

WBC count

<= 11

0

 

> 11

3

hemoglobin

> 9 g/dL

0

 

<= 9 g/dL

1

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 16

• The higher the score the greater the risk for the patient having the acute chest syndrome.

 

Total Score

Risk ACS

0 to 5

low

6 to 10

intermediate

11 to 16

high

 

Performance:

• The area under the ROC curve was 0.84.

 


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