Nazif Joanne M, Taragin Benjamin H, Azzarone Gabriella, Rinke Michael L, Liewehr Sheila, Choi Jaeun, Esteban-Cruciani Nora
1 Children's Hospital at Montefiore, Bronx, NY, USA.
2 Albert Einstein College of Medicine, Bronx, NY, USA.
Clin Pediatr (Phila). 2017 Oct;56(11):1054-1059. doi: 10.1177/0009922817698802. Epub 2017 Mar 21.
Despite recommendations against routine imaging, chest radiography (CXR) is frequently performed on infants hospitalized for bronchiolitis. We conducted a review of 811 infants hospitalized for bronchiolitis to identify clinical factors associated with imaging findings. CXR was performed on 553 (68%) infants either on presentation or during hospitalization; 466 readings (84%) were normal or consistent with viral illness. Clinical factors significantly associated with normal/viral imaging were normal temperature (odds ratio = 1.66; 95% CI = 1.03-2.67) and normal oxygen saturation (odds ratio = 1.77; 95% CI = 1.1-2.83) on presentation. Afebrile patients with normal oxygen saturations were nearly 3 times as likely to have a normal/viral CXR as patients with both fever and hypoxia. Our findings support the limited role of radiography in the evaluation of hospitalized infants with bronchiolitis, especially patients without fever or hypoxia.
尽管有不建议进行常规影像学检查的建议,但对于因细支气管炎住院的婴儿,胸部X线摄影(CXR)仍经常进行。我们对811名因细支气管炎住院的婴儿进行了一项综述,以确定与影像学结果相关的临床因素。553名(68%)婴儿在就诊时或住院期间进行了胸部X线摄影;466份读片结果(84%)正常或与病毒性疾病相符。与正常/病毒性影像学显著相关的临床因素在就诊时为体温正常(比值比=1.66;95%置信区间=1.03-2.67)和血氧饱和度正常(比值比=1.77;95%置信区间=1.1-2.83)。就诊时体温正常且血氧饱和度正常的无发热患者的胸部X线摄影结果正常/为病毒性的可能性几乎是发热且缺氧患者的3倍。我们的研究结果支持了X线摄影在评估因细支气管炎住院的婴儿,尤其是无发热或缺氧的患者中的有限作用。