Table 3.
Characteristics at ICU admission and process of care during the ICU stay.
| Characteristics Median [IQR] or n (%) |
MD | All N = 488 |
AO N = 81 |
No AO N = 407 |
p value |
|---|---|---|---|---|---|
| ICU admission diagnoses | 0 | ||||
| ACS | 232 (47.5) | 40 (49.4) | 192 (47.2) | 0.7 | |
| Severe VOE | 104 (21.3) | 4 (4.9) | 100 (24.6) | < 0.0001 | |
| Sepsis a | 42 (8.6) | 17 (21.3) | 25 (6.1) | < 0.0001 | |
| Pulmonary embolism | 18 (3.7) | 5 (6.3) | 13 (3.2) | 0.19 | |
| Drug /morphine overdose | 12 (2.5) | 3 (3.7) | 9 (2.2) | 0.42 | |
| Other VOEb | 83 (17) | 13 (16) | 70 (17.3) | 0.8 | |
| Other diagnosesc | 48 (9.8) | 17 (21) | 31 (7.6) | 0.0002 | |
| Acute organ failure | 3 | ||||
| Acute respiratory distress | 116 (23.9) | 31 (38.8) | 85 (21) | 0.0008 | |
| Shock | 14 (2.9) | 6 (7.5) | 8 (2) | 0.02 | |
| Coma | 15 (3.1) | 8 (10) | 7 (1.7) | < 0.001 | |
| Acute kidney injury | 3 (0.6) | 1 (1.2) | 2 (0.5) | 0.42 | |
| Multi-organ failure | 7 (1.4) | 7 (8.8) | 0 (0) | < 0.00001 | |
| Vital parameters at ICU admission | |||||
| MBP (mmHg) | 29 | 90 [80–100] | 87 [76–100] | 90 [80–99] | 0.3 |
| Heart rate (beats/min) | 31 | 100 [84–115] | 110 [96–125] | 97 [82–112] | < 0.0001 |
| Respiratory rate (breaths/min) | 117 | 24 [18–30] | 28 [23–32] | 23 [17–28] | < 0.0001 |
| Oxygen saturation (%) | 41 | 98 [96–100] | 98 [96–100] | 99 [96–100] | 0.13 |
| Visual pain scale | 226 | 7 [4–8] | 7 [3–8] | 7 [4–8] | 0.48 |
| GCS score | 42 | 15 [15–15] | 15 [14, 15] | 15 [15–15] | < 0.001 |
| Temperature (°C) | 73 | 37.4[36.9– 38.2] | 37.7 [37–38.6] | 37.3[36.9– 38.1] | 0.33 |
| Laboratory tests at ICU admission | |||||
| Haemoglobin (g/dL) | 10 | 8 [6.7–9.1] | 8.1 [6.2–9.4] | 8 [6.7–9.1] | 0.68 |
| Leucocytes (G/L) | 17 | 15.1 [11–20] | 17 [12.7–24] | 15 [11.2–20] | < 0.0001 |
| Platelets (G/L) | 12 | 264 [170–360] | 192 [123–303] | 276 [183–374] | 0.0002 |
| Creatinine (µmol/L) | 10 | 54 [41–72] | 75 [53–173] | 52 [40–66] | < 0.0001 |
| PT (%) | 45 | 68 [57–78] | 61 [36–71] | 69 [60–78] | < 0.0001 |
| Arterial lactate (mmol/L) | 44 | 0.9 [0.6–1.4] | 1.8 [1–3.5] | 0.8 [0.6–1.2] | < 0.0001 |
| Haemoglobin S (%) | 47 | 77 [59–85] | 68.1 [41.5–75] | 78.9 [60.9 -85.3] | < 0.0001 |
| Haemolytic parameters: | 118 | 1.3 [1–2.3] | 2.1 [1.2–5] | 1.2 [1, 2] | 0.99 |
| ASAT (xN) | 125 | 1 [1–1.7] | 1 [1, 2] | 1 [1–1.6] | 0.42 |
| ALAT (xN) | 197 | 41 [24–77] | 58 [27–103] | 39 [23–71] | 0.16 |
| Total bilirubin (µmol/L) | 221 | 14 [8–28] | 22.5 [11–53] | 13 [823] | 0.009 |
| Direct bilirubin (µmol/L) | 336 | 2.4 [1.7–4.6] | 3.6 [2–10.3] | 2.3 [1.6–3.7] | 0.002 |
| LDH (xN) | |||||
| Treatment in the ICU | |||||
| Opioids | 0 | 391 (80.1) | 60 (74.1) | 331 (81.3) | 0.14 |
| Ketamine | 0 | 115 (23.6) | 9 (11.1) | 106 (26) | 0.005 |
| NSAIDs | 0 | 26 (5.3) | 1 (1.2) | 25 (6.1) | 0.11 |
| Blood transfusion | 0 | 127 (26) | 33 (40.7) | 94 (23.1) | 0.001 |
| Number of RBC packs | 0 | 0 [0–2] | 2 [0–2] | 0 [0–2] | 0.518 |
| Exchange transfusion | 0 | 114 (23.3) | 21 (25.9) | 93 (22.8) | 0.23 |
| Number of RBC packs | 0 | 4 [2–5] | 0 [0–4] | 2 [2–4] | 0.0006 |
| Bloodletting | 12 (2.5) | 0 (0) | 12 (3) | 0.003 | |
| Steroids | 0 | 15 (3.1) | 8 (9.9) | 7 (1.7) | |
| Antibiotics | 361 (73.8) | 71 (87.7) | 289 (71) | ||
| Life-supporting treatments | 0 | ||||
| NIV | 29 (5.9) | 29 (35.8) | 0 (0) | ||
| MV | 46 (9.4) | 46 (56.8) | 0 (0) | ||
| Duration (days) | 5 [2–10] | 5 [2–10] | 0 (0) | ||
| Vasoactive drugs | 32 (6.6) | 32 (39.5) | 0 (0) | ||
| RRT | 18 (3.7) | 18 (22.2) | 0 (0) | ||
| Veno-venous ECMO | 5 (1) | 5 (6.2) | 0 (0) | ||
| Arterio-venous ECMO | 3 (0.6) | 29 (35.8) | |||
| SAPS II | 88 | 16 [10–25] | 34 [24–41] | 15 [10–22] | < 0.0001 |
Significant values are in [bold].
The p values were obtained by univariate logistic regression and reflect associations with the occurrence of adverse outcomes.
IQR interquartile range, MD missing data, AO adverse outcome defined as death or use of life-sustaining treatments, SCD sickle cell disease, MBP mean arterial blood pressure, GCS Glasgow Coma Scale, ASAT aspartate transaminase, ALAT alanine transaminase, LDH lactate dehydrogenase, PT prothrombin time, ICU intensive care unit, NSAIDs nonsteroidal anti-inflammatory drugs, RBC red blood cells, LOS length of stay, ACS acute chest syndrome, VO vaso-occlusive, VOE vaso-occlusive event, NIV non-invasive ventilation, MV endotracheal mechanical ventilation, RRT renal replacement therapy, ECMO extracorporeal membrane oxygenation, SAPS II Simplified Acute Physiology Score II.
aSepsis was suspected when mentioned in medical records and confirmed when the patient had an infection accompanied with a life-threatening organ dysfunction.
bIncluding delayed haemolytic transfusion reaction, stroke, acute anaemia, priapism, splenic sequestration, VOE without severe pain, and VOE after surgery or childbirth.
cIncluding cardiac arrest, pulmonary oedema, acute coronary syndrome, exacerbation of chronic respiratory failure, seizure and status epilepticus, acute kidney failure, metabolic disorders, pancreatitis, hepatitis, gastro-intestinal bleeding, gastro-intestinal occlusion, mesenteric ischaemia, haematologic disorders, anaphylaxis, and peri-partum complications.