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AAP Grand Rounds 3:45-46 (2000) Predicting Adverse Outcomes in Sickle Cell DiseaseSource: Miller ST, Sleeper LA, Pegelow CH, et al. Prediction of adverse outcomes in children with sickle cell disease. N Engl J Med. 2000;342:8389.
Knowing which children with sickle cell anemia are most likely to develop complications might help pediatricians to tailor therapy, counsel families, and design research studies for new treatments. Miller et al sought to determine early predictors of complications of sickle cell disease in a prospective study of 392 children followed from early infancy to about age 10. In multiple sites across the United States, 414 infants with homozygous sickle cell anemia or sickle cellß°-thalassemia were enrolled before age 6 months. Twenty-two (5%) were lost to follow-up. Of 392 remaining children, 70 (18%) had an adverse outcome, defined as death (n=18), stroke (n=25), frequent pain (average of 2 events/year, n=17), or recurrent
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