Korean J Pediatr.  2016 Dec;59(12):471-476. 10.3345/kjp.2016.59.12.471.

Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study

Affiliations
  • 1Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea. epirubicin13@gmail.com
  • 2Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 3Department of Radiology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

Abstract

PURPOSE
Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis.
METHODS
We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography.
RESULTS
The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05).
CONCLUSION
The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings.

Keyword

Bronchiolitis; C-reactive protein; Radiography

MeSH Terms

Blood Cell Count
Bronchiolitis*
C-Reactive Protein
Child*
Fever
Heart Rate
Hospitalization
Humans
Logistic Models
Oxygen
Pulmonary Atelectasis
Radiography
Radiography, Thoracic*
Respiratory Rate
Thorax*
C-Reactive Protein
Oxygen
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