Beyyumi Ela, Tawil Mohamed I, AlDhanhani Huda, Jameel Sara, Mouhssine Manal, AlNuaimi Hasa M, Hamdoun Osama, Alabdouli Amnah, Alsamri Mohammed T, Ghatasheh Ghassan A, Zoubeidi Taoufik, Souid Abdul-Kader
Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates.
Department of Radiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Front Pediatr. 2021 Aug 19;9:722480. doi: 10.3389/fped.2021.722480. eCollection 2021.
Risks of diagnostic radiation have become more notable lately, particularly in young children with chronic medical conditions. This study reports on the cumulative radiation from chest radiographs in children with asthma. Its main purpose was to review our current practice and suggest minimizing the use of chest radiographs. The study was retrospective and conducted at a pediatric tertiary center. Eligibility criteria included children 2-15 y, admitted between January 2017 and December 2018 for asthma management. Of the 643 children admitted as "asthma exacerbation," 243 [40% females; age (mean ± SD) 5.4±3.3 y] met the study criteria for inclusion. Ninety-two (38%) children had a temperature of 38.8±0.7°C on the day of admission. Antibiotics were prescribed for 148 (61%) children, mainly for presumed pneumonia. Chest radiographs were requested for 214 (88%) children, mainly on the day of admission. Only 38 (18%) chest radiographs showed focal/multifocal pneumonia justifying antibiotic use. Significant predictors for requesting chest radiographs were antibiotic use for presumed pneumonia, lower oxygen saturation at presentation, and a requested blood culture. The rate of chest radiographs per year was negatively related to the child's age; the younger the child the higher the rate (model coefficient -0.259, < 0.001). For children < 5 y, the rate of chest radiographs was 1.39 ± 1.21/y and radiation dose 0.028 ± 0.025 mSv/y. The corresponding rates for children ≥5 y were 0.78 ± 0.72/y and 0.008 ± 0.007 mSv/y, respectively ( < 0.001). Chest radiographs were commonly requested for children with asthma, especially younger children. Prospective studies are necessary to measure the impact of this practice on the children's health.
诊断性辐射的风险近来愈发显著，尤其是在患有慢性疾病的幼儿中。本研究报告了哮喘患儿胸部X光片的累积辐射情况。其主要目的是回顾我们目前的做法，并建议尽量减少胸部X光片的使用。该研究为回顾性研究，在一家儿科三级中心进行。纳入标准包括2017年1月至2018年12月期间因哮喘管理入院的2至15岁儿童。在643名以“哮喘加重”入院的儿童中，243名（40%为女性；年龄[平均±标准差]5.4±3.3岁）符合纳入研究标准。92名（38%）儿童入院当天体温为38.8±0.7°C。148名（61%）儿童使用了抗生素，主要用于疑似肺炎。214名（88%）儿童被要求进行胸部X光检查，主要在入院当天。只有38张（18%）胸部X光片显示有局灶性/多灶性肺炎，证明使用抗生素合理。要求进行胸部X光检查的显著预测因素是因疑似肺炎使用抗生素、入院时较低的血氧饱和度以及要求进行血培养。每年胸部X光检查的比率与儿童年龄呈负相关；儿童年龄越小，比率越高（模型系数-0.259，<0.001）。对于<5岁的儿童，胸部X光检查的比率为1.39±1.21/年，辐射剂量为0.028±0.025毫希沃特/年。≥5岁儿童的相应比率分别为0.78±0.72/年和0.008±0.007毫希沃特/年（<0.001）。哮喘患儿通常被要求进行胸部X光检查，尤其是年幼的儿童。有必要进行前瞻性研究以衡量这种做法对儿童健康的影响。
