Centre for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Acta Paediatr. 2021 May;110(5):1594-1600. doi: 10.1111/apa.15692. Epub 2020 Dec 7.
Our aim was to evaluate the impact of the 2014 Finnish Current Care Guidelines for paediatric lower respiratory tract infections (LRTIs), particularly on taking of chest radiographs.
This study used official national data and regional (Pirkanmaa) data on children aged 0-16 years who underwent chest radiographs in 2011 and 2015. We also collected data for LRTI diagnoses from local registers, including prescribed antibiotics and taking of chest radiographs. The local cohort comprised children aged 0-15 who presented to the primary care emergency room or to the hospital emergency department (Tampere university hospital) in November-December 2012-2015.
Chest radiographs for Finnish children aged 0-16 fell from 2011 to 2015: by 15.9% nationally and by 16.9% in Pirkanmaa. When asylum seekers with chest radiographs for tuberculosis screening were excluded, the estimated national reduction was 29.9%. In the local cohort, chest radiographs increased from 82 to 139 (69.5%) between 2012/2013 and 2014/2015 as the occurrence of community-acquired pneumonia (CAP) increased. However, the proportion of patients with CAP who had chest radiograph taken tended to decrease from 84.6% to 71.3% (p = 0.078).
Decreases in national and regional chest imaging trends were observed after the 2014 guidance for children`s LRTI was introduced.
我们旨在评估 2014 年芬兰儿科下呼吸道感染（LRTI）现行护理指南的影响，特别是对拍摄胸片的影响。
本研究使用了 2011 年和 2015 年全国性和区域性（皮尔卡区）0-16 岁儿童拍摄胸片的数据。我们还从当地登记处收集了 LRTI 诊断数据，包括处方抗生素和拍摄胸片。当地队列包括 2012-2015 年 11-12 月在初级保健急诊室或医院急诊室（坦佩雷大学医院）就诊的 0-15 岁儿童。
芬兰 0-16 岁儿童的胸片数量从 2011 年到 2015 年下降：全国下降 15.9%，皮尔卡区下降 16.9%。当排除因结核病筛查而拍摄胸片的寻求庇护者后，全国估计减少 29.9%。在当地队列中，2012/2013 年至 2014/2015 年，因社区获得性肺炎（CAP）的发生，胸片数量从 82 张增加到 139 张（69.5%）。然而，拍摄胸片的 CAP 患者比例从 84.6%下降到 71.3%（p=0.078）。
在 2014 年儿童 LRTI 指南发布后，观察到全国和地区胸部成像趋势下降。
