The PRESEV score (ACS-predictive score) helps predict the onset of acute chest syndrome during vaso-occlusive crises.
The indications according to the value are:
Score ≤ 5: Low risk.
Score ≥ 6 and ≤ 10: Intermediate risk.
Score ≥ 11: High risk.
Vaso-occlusive crisis (VOC) in sickle cell disease results from the sickling of red blood cells under the effect of oxidative stress triggered by many situations. Hemoglobin polymerizes within the red blood cell, it becomes difficult to deform and clogs the blood capillaries. As a direct consequence of this vascular occlusion, the obstructed blood capillaries to the bones are the cause of particularly painful bone infarctions bringing sickle cell patients to the Emergency Department.
CVO pain can potentially affect every bone in the body.
They are most often located in the long bones (humerus, femurs, tibias) and spine. A fever linked to the crisis is possible but does not generally exceed 38.5°C and in itself justifies antibiotic treatment covering the pneumococcus in patients without a functional spleen.