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Clinical Factors Associated With Chest Imaging Findings in Hospitalized Infants With Bronchiolitis

Joanne M Nazif1,2, Benjamin H Taragin1,2, Gabriella Azzarone1,2

  • 11 Children's Hospital at Montefiore, Bronx, NY, USA.

Clinical Pediatrics
|September 6, 2017
PubMed

Insights

Routine chest radiography (CXR) for infants hospitalized with bronchiolitis is often unnecessary. Normal temperature and oxygen saturation on presentation are key indicators of normal or viral findings on CXR.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Radiology

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • Chest radiography (CXR) is frequently used in hospitalized infants with bronchiolitis, despite guidelines against routine imaging.

Purpose of the Study:

  • To identify clinical factors associated with imaging findings in infants hospitalized for bronchiolitis.
  • To evaluate the utility of CXR in this patient population.

Main Methods:

  • Retrospective review of 811 infants hospitalized for bronchiolitis.
  • Analysis of clinical data and CXR findings on presentation and during hospitalization.
  • Statistical analysis to determine factors associated with imaging results.

Main Results:

  • CXR was performed on 68% of infants; 84% of readings were normal or consistent with viral illness.
  • Normal temperature (OR=1.66) and normal oxygen saturation (OR=1.77) on presentation were significantly associated with normal/viral CXR findings.
  • Afebrile infants with normal oxygen saturation were nearly 3 times more likely to have normal/viral CXR compared to febrile infants with hypoxia.

Conclusions:

  • The findings support a limited role for routine radiography in evaluating hospitalized infants with bronchiolitis.
  • CXR is particularly less indicated in patients presenting without fever or hypoxia.
  • Clinical assessment of temperature and oxygen saturation can help guide imaging decisions.

Keywords:
bronchiolitisfeverhypoxiaimaginginfantradiography

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