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Blood, 15 January 2008, Vol. 111, No. 2, pp. 544-548. Prepublished online as a Blood First Edition Paper on October 1, 2007; DOI 10.1182/blood-2007-07-100719. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-07-100719v1 111/2/544    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Quinn, C. T. Articles by Buchanan, G. R. Search for Related Content PubMed PubMed Citation Articles by Quinn, C. T. Articles by Buchanan, G. R. Related Collections Free Research Articles Clinical Trials and Observations Red Cells Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Prediction of adverse outcomes in children with sickle cell anemia: a study of the Dallas Newborn Cohort Charles T. Quinn1,3, Nancy J. Lee2,3, Elizabeth P. Shull2,3, Naveed Ahmad3, Zora R. Rogers1,3, and George R. Buchanan1,3 1 Division of Hematology-Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas; 2 Southwestern Comprehensive Sickle Cell Center, Dallas, TX; and 3 Children's Medical Center, Dallas, TX The Cooperative Study of Sickle Cell Disease reported that dactylitis, severe anemia, and leukocytosis in very young children with sickle cell disease (SCD) increased the risk of later adverse outcomes, including death, stroke, frequent pain, and recurrent acute chest syndrome. This model has not been validated in other cohorts. We evaluated its performance in the Dallas Newborn Cohort, a newborn inception cohort of children with SCD. We studied 168 children (55% male, 97% sickle cell anemia) with a mean follow-up of 7.1 years who provided 1188 patient-years of observation. Of the 23 (13.7%) subjects who experienced adverse events, 2 (1.2%) died, 14 (8.3%) had a stroke, 4 (2.4%) had frequent pain, and 3 (1.8%) had recurrent acute chest syndrome. No relationship existed between early clinical predictors and later adverse outcomes, with the possible exception of leukocyte count. Most subjects who experienced adverse events were predicted to be at low risk for those events. No subject who was predicted to be at high risk actually experienced an adverse outcome. The sensitivity of the model did not rise above 20% until specificity fell below 60%. We suggest that this model not be used as a criterion to initiate early interventions for SCD. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Sickle severity selectors strike out Ellis J. Neufeld Blood 2008 111: 479. [Full Text] [PDF]

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