Asthma IN SICKLE CELL DISEASE as A RISK FACTOR for Acute Chest Syndrome IN Pediatric PATIENTS.

Both asthma and sickle cell disease are major Public Health concerns. Previous studies have demonstrated that asthma among children with sickle cell disease (SCD) may increase the risk of developing acute chest syndrome (ACS), which can be life threatening. These respiratory complications may increase emergency department (ED) utilization, increase health care costs, and reduce life span among persons with SCD. The purpose of this study is to determine whether children with SCD and asthma have significantly more ED visits and if they are at higher risk of developing ACS compared to children with SCD who do not have asthma.

We used MarketScan® Multi-State Medicaid Databases from Thompson Reuters (Ann Arbor, Michigan) for the years 2001 to 2005. These are proprietary datasets covering eight unidentified states. We used International Classification of Disease, 9^th Division, Clinical Modifications (ICD-9-CM) codes to identify SCD, asthma and ACS.

In 2005, there were 2428 children with SCD continuously enrolled in Medicaid. Among those, 369 (15.2%) patients were identified as having asthma. The mean number of emergency department visits was significantly higher among children with both SCD and asthma compared to children with SCD without asthma (p<0.05). In addition, children with SCD and asthma were more likely to have at least one episode of ACS than children with SCD without asthma (28.2% vs. 7.8%, respectively).

Among children with SCD who are enrolled in Medicaid, asthma is a common comorbidity, which is associated with high incidence of ACS. Therefore asthma should be aggressively managed among SCD patients. Proper management of asthma may result not only in reduced pulmonary complications, but also reduced costs related to emergency department utilization and progression of lung disease into adulthood.

No relevant conflicts of interest to declare.