Artigo de Periódico
Severity of childhood community-acquired pneumonia and chest radiographic findings
Fecha
2009Registro en:
8755-6863
v. 44, n. 3
Autor
Key, Ng Kin
Araujo Neto, Cesar Augusto de
Carvalho, Cristiana Maria Costa Nascimento de
Institución
Resumen
To assess if chest radiographic findings present on admission are associated with severity of childhood community-acquired pneumonia (CAP), a total of 161 children hospitalized with pulmonary infiltrate were enrolled in the study; 48 (30%) patients were excluded because of presence of bilateral chest radiographic alterations (33; 20%) and presence of underlying diseases (15; 9%). According to WHO and BTS criteria, severe CAP was present in 57 (50%) and in 96 (85%) cases, respectively; 29 (26%) were aged less than 1 year. The median age (months) was 22 (mean 24 ± 14, range 2–58). Overall, radiographic finding was right-sided in 77 (68%) cases and the upper lobe was compromised in 36 (32%) cases. By analyzing data stratified to age, the frequency of upper lobe involvement was significantly higher among severe cases (WHO criteria) only for those patients aged ≥1 year (13/35 [37%] vs. 7/45 [16%], P = 0.03, OR [95% CI] 3.2 [1.1–9.2]). The specificity and positive predictive value of upper lobe involvement for severity among the latter group of patients were 84% (95% CI 70–93%) and 65% (95% CI 41–84%), respectively. No association was found by using the BTS criteria. The admission chest radiography was useful to predict severity of children aged ≥1 year hospitalized with CAP. Pediatr Pulmonol. 2009; 44:249–252. © 2009 Wiley-Liss, Inc.