Evidence map›Paper›PMID 17849474›Full record

Trial reportPediatric blood & cancer2008

Corticosteroids and increased risk of readmission after acute chest syndrome in children with sickle cell disease.

John J Strouse, Clifford M Takemoto, Jeffrey R Keefer, Gregory J Kato, James F Casella

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric blood & cancer, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 4 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 4 syntheses or guidelines pooled it, 117 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
  6. Review
  7. Review
  8. Respiratory management of acute chest syndrome in children with sickle cell disease.European respiratory review : an official journal of the European Respiratory Society · 2024
    Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Evidence-based obstetric management of women with sickle cell disease in low-income countries.Hematology. American Society of Hematology. Education Program · 2022
    Article
  14. COVID-19 outcomes in sickle cell disease and sickle cell trait.Best practice & research. Clinical haematology · 2022
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

John J StrouseDivision of Pediatric Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. jstrous1@jhmi.edu
Clifford M Takemoto
Jeffrey R Keefer
Gregory J Kato
James F Casella
Johns Hopkins University · USJohns Hopkins Medicine · US

Funding

Natural History of Sickle Cell Disease and Other Hemolytic DisordersZIAHL006014 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI KATO, GREGORY · 2009 to 2014
$2.7M
Natural History of Sickle Cell Disease and Other Hemolytic DisordersZ01CL008070 · CLC · CLINICAL CENTER · PI MACHADO, ROBERTO F · 2004 to 2008
$44k
Intramural NIH HHS Z01 CL008070Intramural NIH HHS Z99 HL999999Intramural NIH HHS ZIA HL006014NCRR NIH HHS K12RR01627
6 · The paper itself

Abstract

backgroundAcute chest syndrome (ACS) is a frequent cause of hospitalization and mortality in children with sickle cell disease. Transfusion is often required to prevent respiratory failure and treatment with dexamethasone may reduce the length of admission and the need for transfusions. We performed a retrospective cohort study to evaluate risk factors for readmission and prolonged hospitalization after different treatments for ACS. PROCEDURE: We identified patients <22 years of age hospitalized with ACS at Johns Hopkins Hospital from January 1998 to April 2004 using the hospitals discharge database and by reviewing dictated summaries.

resultsWe identified 65 patients with 129 episodes of ACS (mean age 12.5 years, range 1.2-21.9 years). Thirty-nine episodes were treated with corticosteroids and 51 with transfusions. Patients were readmitted within 14 days after 23 episodes (18%). Readmission was strongly associated with report of an inhaler or nebulizer at home [odds ratio (OR) 6.0, P < 0.05], diastolic BP at 48 hr (OR 1.8 per 10 mm increase, P<0.01), corticosteroids (OR 20, P < 0.005), or transfusion (OR 0.03, P < 0.05). Treatment with corticosteroids alone (P < 0.05) and older age (P < 0.001) were associated with longer hospitalization.

conclusionsThese results demonstrate a greatly elevated independent risk of readmission after ACS in children with asthma and after treatment with corticosteroids and a protective effect of transfusion. Although dexamethasone has documented efficacy for reducing the duration of ACS, the substantial risk of readmission for pain should limit its use.

Indexed as

Acute DiseaseAdolescentAdultAnemia, Sickle CellAsthmaBlood TransfusionChildChild, PreschoolCohort StudiesDexamethasoneFemaleGlucocorticoidsHospitalizationHumansInfantLung DiseasesDexamethasoneGlucocorticoidsPrednisolonePrednisone

Identifiers

PMID17849474
PMCPMC2757656
OpenAlexW1975642553

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.