2017, Number 1
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Rev Mex Pediatr 2017; 84 (1)
Chest X-ray and length of stay in pediatric patients with lower respiratory tract infections
Carrillo-Bayona JA, Ardila-Sánchez M, Martínez-Montero JV, Castellanos-Reyes MJ, Vallejo-Díaz JF, Vásquez-Hoyos P
Language: Spanish
References: 13
Page: 15-20
PDF size: 266.71 Kb.
ABSTRACT
Introduction: The acute respiratory tract infection has high rates of morbidity and mortality in children under five years of age, with more than 2 million deaths per year. The chest radiograph plays a major role in the diagnosis of suspected pneumonia and the detection of complications. Bogota is 2,640 meters above sea level, which makes the population more susceptible to hypoxemia.
Objective: To identify whether the chest radiograph on admission in children younger than five years of age with acute lower respiratory tract infection, predicts hospital length of stay.
Material and methods: A cohort study was carried out in hospitalized patients with acute lower respiratory tract infection. We compare the main radiographic findings versus the length of hospital stay. A multiple linear regression model was used to rule out confounders.
Results: 196 patients were included. The bivariate and multivariate analysis showed a statistically significant relationship between the days of hospital stay and the variables: consolidation on admission chest X-ray, fever, lower age and requirement of home O
2. No relationship was found to the final clinical diagnosis or other radiological findings.
Conclusion: A consolidation on the admission chest X-ray, in addition to other variables such as lower age at admission, fever and the need for home oxygen, is a good predictor of longer hospital stay in children with a low acute respiratory infection.
REFERENCES
Ducassou S, Rivaud D, Auvrignon A, Vérité C, Bertrand Y, Gandemer V et al. Invasive fungal infections in pediatric acute myelogenous leukemia. Pediatr Infect Dis J. 2015; 34(11): 1262-1264.
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner society: glossary of terms for thoracic imaging. Radiology. 2008; 246(3): 697-722.
Sahbudak Bal Z, Yilmaz-Karapinar D, Karadas N, Sen S, Onder-Sivis Z, Akinci AB et al. Proven and probable invasive fungal infections in children with acute lymphoblastic leukaemia: results from an university hospital, 2005-2013. Mycoses. 2015; 58(4): 225-232.
Gereige RS, Laufer PM. Pneumonia. Pediatr Rev. 2013; 34(10): 438-456.
Saugel B, Gramm C, Wagner JY, Messer M, Lahmer T, Meidert AS et al. Evaluation of a dosing regimen for continuous vancomycin infusion in critically ill patients: an observational study in intensive care unit patients. J Crit Care. 2014; 29(3): 351-355.
Portugal RD, Garnica M, Nucci M. Index to predict invasive mold infection in high-risk neutropenic patients based on the area over the neutrophil curve. J Clin Oncol. 2009; 27(23): 3849-3854.
Garnica M, Sinhorelo A, Madeira L, Portugal R, Nucci M. Diagnostic-driven antifungal therapy in neutropenic patients using the D-index and serial serum galactomannan testing. Braz J Infect Dis. 2016; 20 (4): 354-359.
Barton CD, Waugh LK, Nielsen MJ, Paulus S. Febrile neutropenia in children treated for malignancy. J Infect. 2015; 71 Suppl 1: S27-S35.
Neuman MI, Monuteaux MC, Scully KJ, Bachur RG. Prediction of pneumonia in a pediatric emergency department. Pediatrics. 2011; 128(2): 246-253.
Social. INdSMdP. Protocolo de vigilancia y control de infección respiratoria aguda. In: Colombia B-, editor. Guía infección respiratoria aguda. INS2013. p. 1-23.
Le J, Bradley JS, Murray W, Romanowski GL, Tran TT, Nguyen N et al. Improved vancomycin dosing in children using area under the curve exposure. Pediatr Infect Dis J. 2013; 32 (4): e155-e163.
Kimura S, Oshima K, Sato K, Sato M, Terasako K, Nakasone H et al. Retrospective evaluation of the area over the neutrophil curve index to predict early infection in hematopoietic stem cell transplantation recipients. Biol Blood Marrow Transplant. 2010; 16 (10): 1355-1361.
Yilmaz G, Coşkun B, Elhan A, Azap A, Akan H. D-index: a new scoring system in febrile neutropenic patients for predicting invasive fungal infections. Turk J Haematol. 2016; 33(2): 102-106.