Nationwide retrospective study of critically ill adults with sickle cell disease in France
Abstract Little is known about patients with sickle cell disease (SCD) who require intensive care unit (ICU) admission. The goals of this study were to assess outcomes in patients admitted to the ICU for acute complications of SCD and to identify factors associated with adverse outcomes. This multic...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/998cf3b3f4ca4aed85d72460396144b3 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:998cf3b3f4ca4aed85d72460396144b3 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:998cf3b3f4ca4aed85d72460396144b32021-12-05T12:14:42ZNationwide retrospective study of critically ill adults with sickle cell disease in France10.1038/s41598-021-02437-22045-2322https://doaj.org/article/998cf3b3f4ca4aed85d72460396144b32021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02437-2https://doaj.org/toc/2045-2322Abstract Little is known about patients with sickle cell disease (SCD) who require intensive care unit (ICU) admission. The goals of this study were to assess outcomes in patients admitted to the ICU for acute complications of SCD and to identify factors associated with adverse outcomes. This multicenter retrospective study included consecutive adults with SCD admitted to one of 17 participating ICUs. An adverse outcome was defined as death or a need for life-sustaining therapies (non-invasive or invasive ventilation, vasoactive drugs, renal replacement therapy, and/or extracorporeal membrane oxygenation). Factors associated with adverse outcomes were identified by mixed multivariable logistic regression. We included 488 patients admitted in 2015–2017. The main reasons for ICU admission were acute chest syndrome (47.5%) and severely painful vaso-occlusive event (21.3%). Sixteen (3.3%) patients died in the ICU, mainly of multi-organ failure following a painful vaso-occlusive event or sepsis. An adverse outcome occurred in 81 (16.6%; 95% confidence interval [95% CI], 13.3%–19.9%) patients. Independent factors associated with adverse outcomes were low mean arterial blood pressure (adjusted odds ratio [aOR], 0.98; 95% CI 0.95–0.99; p = 0.027), faster respiratory rate (aOR, 1.09; 95% CI 1.05–1.14; p < 0.0001), higher haemoglobin level (aOR, 1.22; 95% CI 1.01–1.48; p = 0.038), impaired creatinine clearance at ICU admission (aOR, 0.98; 95% CI 0.97–0.98; p < 0.0001), and red blood cell exchange before ICU admission (aOR, 5.16; 95% CI 1.16–22.94; p = 0.031). Patients with SCD have a substantial risk of adverse outcomes if they require ICU admission. Early ICU admission should be encouraged in patients who develop abnormal physiological parameters.Maïté AgbakouArmand Mekontso-DessapMorgane PereGuillaume VoiriotMuriel PicardJérémy BourenneStephan EhrmannEmmanuel CanetAlexandre BoyerSaad NseirFabienne TamionArnaud W. ThilleLaurent ArgaudEmmanuel PontisJean-Pierre QuenotFrancis SchneiderArnaud HotGilles CapellierCécile AubronKeyvan RazaziAgathe MasseauNoëlle BruleJean ReignierJean-Baptiste LascarrouNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Maïté Agbakou Armand Mekontso-Dessap Morgane Pere Guillaume Voiriot Muriel Picard Jérémy Bourenne Stephan Ehrmann Emmanuel Canet Alexandre Boyer Saad Nseir Fabienne Tamion Arnaud W. Thille Laurent Argaud Emmanuel Pontis Jean-Pierre Quenot Francis Schneider Arnaud Hot Gilles Capellier Cécile Aubron Keyvan Razazi Agathe Masseau Noëlle Brule Jean Reignier Jean-Baptiste Lascarrou Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| description |
Abstract Little is known about patients with sickle cell disease (SCD) who require intensive care unit (ICU) admission. The goals of this study were to assess outcomes in patients admitted to the ICU for acute complications of SCD and to identify factors associated with adverse outcomes. This multicenter retrospective study included consecutive adults with SCD admitted to one of 17 participating ICUs. An adverse outcome was defined as death or a need for life-sustaining therapies (non-invasive or invasive ventilation, vasoactive drugs, renal replacement therapy, and/or extracorporeal membrane oxygenation). Factors associated with adverse outcomes were identified by mixed multivariable logistic regression. We included 488 patients admitted in 2015–2017. The main reasons for ICU admission were acute chest syndrome (47.5%) and severely painful vaso-occlusive event (21.3%). Sixteen (3.3%) patients died in the ICU, mainly of multi-organ failure following a painful vaso-occlusive event or sepsis. An adverse outcome occurred in 81 (16.6%; 95% confidence interval [95% CI], 13.3%–19.9%) patients. Independent factors associated with adverse outcomes were low mean arterial blood pressure (adjusted odds ratio [aOR], 0.98; 95% CI 0.95–0.99; p = 0.027), faster respiratory rate (aOR, 1.09; 95% CI 1.05–1.14; p < 0.0001), higher haemoglobin level (aOR, 1.22; 95% CI 1.01–1.48; p = 0.038), impaired creatinine clearance at ICU admission (aOR, 0.98; 95% CI 0.97–0.98; p < 0.0001), and red blood cell exchange before ICU admission (aOR, 5.16; 95% CI 1.16–22.94; p = 0.031). Patients with SCD have a substantial risk of adverse outcomes if they require ICU admission. Early ICU admission should be encouraged in patients who develop abnormal physiological parameters. |
| format |
article |
| author |
Maïté Agbakou Armand Mekontso-Dessap Morgane Pere Guillaume Voiriot Muriel Picard Jérémy Bourenne Stephan Ehrmann Emmanuel Canet Alexandre Boyer Saad Nseir Fabienne Tamion Arnaud W. Thille Laurent Argaud Emmanuel Pontis Jean-Pierre Quenot Francis Schneider Arnaud Hot Gilles Capellier Cécile Aubron Keyvan Razazi Agathe Masseau Noëlle Brule Jean Reignier Jean-Baptiste Lascarrou |
| author_facet |
Maïté Agbakou Armand Mekontso-Dessap Morgane Pere Guillaume Voiriot Muriel Picard Jérémy Bourenne Stephan Ehrmann Emmanuel Canet Alexandre Boyer Saad Nseir Fabienne Tamion Arnaud W. Thille Laurent Argaud Emmanuel Pontis Jean-Pierre Quenot Francis Schneider Arnaud Hot Gilles Capellier Cécile Aubron Keyvan Razazi Agathe Masseau Noëlle Brule Jean Reignier Jean-Baptiste Lascarrou |
| author_sort |
Maïté Agbakou |
| title |
Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| title_short |
Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| title_full |
Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| title_fullStr |
Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| title_full_unstemmed |
Nationwide retrospective study of critically ill adults with sickle cell disease in France |
| title_sort |
nationwide retrospective study of critically ill adults with sickle cell disease in france |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/998cf3b3f4ca4aed85d72460396144b3 |
| work_keys_str_mv |
AT maiteagbakou nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT armandmekontsodessap nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT morganepere nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT guillaumevoiriot nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT murielpicard nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT jeremybourenne nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT stephanehrmann nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT emmanuelcanet nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT alexandreboyer nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT saadnseir nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT fabiennetamion nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT arnaudwthille nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT laurentargaud nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT emmanuelpontis nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT jeanpierrequenot nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT francisschneider nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT arnaudhot nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT gillescapellier nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT cecileaubron nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT keyvanrazazi nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT agathemasseau nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT noellebrule nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT jeanreignier nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance AT jeanbaptistelascarrou nationwideretrospectivestudyofcriticallyilladultswithsicklecelldiseaseinfrance |
| _version_ |
1718372146186551296 |