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Chest Radiography Use in Hospitalized Children with Acute Respiratory Tract Infections: A Baseline Analysis for

Roxana Axinte1,2, Sorin Axinte3,4, Elena Tătăranu2,3

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Pediatric chest X-rays are overused in young children with respiratory infections, especially when guidelines suggest otherwise. This study highlights the need for targeted interventions to reduce unnecessary imaging and radiation exposure in this vulnerable population.

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chest radiographydiagnostic stewardshipimaging optimizationpediatric emergency carepediatric respiratory infectionsquality improvementradiation exposure

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Area of Science:

  • Pediatric radiology
  • Respiratory medicine
  • Healthcare quality improvement

Background:

  • Pediatric respiratory infections are a major cause of emergency department visits and hospitalizations.
  • Chest X-rays are frequently used despite guidelines recommending restrictive imaging, especially for uncomplicated cases in young children.
  • Overutilization of imaging raises concerns about radiation exposure and resource allocation.

Purpose of the Study:

  • Quantify potentially unnecessary chest radiography in hospitalized pediatric patients with respiratory infections.
  • Identify age-related and diagnostic patterns for targeted imaging optimization.
  • Provide data for quality improvement initiatives to reduce pediatric imaging.

Main Methods:

  • Retrospective observational study of pediatric patients in a Romanian tertiary county hospital over 12 months.
  • Analysis of electronic medical records for respiratory diagnoses, hospitalization, age, and chest radiography use.
  • Statistical analysis to identify imaging patterns and correlations.

Main Results:

  • Over 26,000 pediatric emergency presentations included; 1212 children hospitalized with respiratory infections.
  • 3414 chest radiographs performed, with highest use in children aged 0-4 years.
  • Negative correlation between patient age and imaging frequency (r = -0.70, p < 0.001); repeated imaging common in pneumonia, bronchiolitis.

Conclusions:

  • Thoracic radiographs are disproportionately used in young children with respiratory infections.
  • Imaging is often employed in conditions with limited indications, particularly in younger age groups.
  • Findings establish a baseline for interventions to reduce unnecessary pediatric imaging and radiation exposure.