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

Description

Bartolucci et al developed a score for predicting the risk of the acute chest syndrome developing in an adult sickle cell patient with a vaso-occlusive crisis (VOC). This can help to decide if the patient can be discharged or if the patient should receive more aggressive management. The authors are from Henri-Mondor Hospital-UPEC in Creteil, France.


Patient selection: adult patient with sickle cell disease experiencing a vaso-occlusive crisis (VOC)

 

Outcome: acute chest syndrome (ACS)

 

Parameters:

(1) absolute reticulocyte count in 10^9/L

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

(3) leukocyte (WBC) count in 10^9/L

(4) hemoglobin in g/dL

 

Categorical Pain

Score

none

0

mild, not increased by mobilization

1

moderate, increased by mobilization

2

severe, with disability

3

 

 

Parameter

Finding

Points

absolute reticulocyte count

<= 216 * 10^9/L

0

 

> 216 * 10^9/L

6

categorical pain score

0 or 1

0

 

2

4

 

3

6

leukocyte count

<= 11 * 10^9/L

0

 

> 11 * 10^9/L

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 of the acute chest syndrome (ACS).

 

Total Score

Risk ACS

0 to 5

low

6 to 10

intermediate

11 to 16

high

 

Performance:

• The area under the ROC curve is 0.84.


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