胸部X射线影像在患有喘的儿童中的使用趋势和相关性 喘恶化
Robert M Hoffmann1,2, Michael C Monuteaux1,2, Cynthia A Gravel1,2
1Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
Pediatrics
|January 6, 2026
概括
胸部放射 (CXR) 经常用于儿童喘恶化,尽管有指导方针反对它. 这种常见的,可变的做法与更多的肺炎诊断和复诊有关,表明需要进行干预.
科学领域:
- 儿科急救医学 儿科急救医学
- 放射学和成像学 放射学和成像学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 胸部X射线图 (CXR) 经常在儿科急诊室 (ED) 获得喘恶化,这与指导方针相反.
- 这种实践的临床影响和医院一级变化尚不清楚.
研究的目的:
- 评估儿童喘恶化CXR利用的趋势和医院间变化.
- 为了确定与CXR使用相关的患者和医院因素.
- 评估CXR利用的下游结果.
主要方法:
- 利用儿科健康信息系统 (PHIS) 数据库对患有喘 (2016-2024) 的儿童 (2-18岁) 的ED遭遇进行了分析.
- 通过诊断代码和阿尔布特罗尔的管理,确定了喘恶化.
- 采用多变量后勤回归来分析CXR趋势,预测因素和结果.
主要成果:
- 在145,059名患有喘恶化症的儿童中,CXRs在22.3%的儿童中进行.
- 在CXR使用方面没有总体的时间趋势,但肺炎病例下降.
- 显著的医院变化 (13.1%-37.7%);与年轻年龄,女性性别,白人种族,私人保险和冬季相关的使用率较高.
- 高CXR率的医院有更多的肺炎诊断和3天的复诊.
结论:
- 在儿科喘恶化中使用CXR是常见的,高度可变的,并且与增加的肺炎诊断和复诊有关.
- 持续的低值成像表明,医院的做法会影响诊断标签和结果.
- 需要采取决策支持和基准测试等干预措施,以减少不必要的成像和促进基于证据的护理.
相关概念视频
01:30Radiological Investigation I: X-ray and CT
1.0K
Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
1.0K
01:27Pneumothorax-II
884
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
884
01:20Imaging Studies for Cardiovascular System III: X-Ray
462
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
462
01:23Assessment of Respiration
1.8K
The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.8K
01:30Asthma-IV: Diagnostic and Management
3.1K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
3.1K
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
762
Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
762