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• W4200593973 abstract "Research Article| October 01 2021 Chest Radiograph Utility in Children With Asthma and Chest Pain AAP Grand Rounds (2021) 46 (4): 43. https://doi.org/10.1542/gr.46-4-43 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Chest Radiograph Utility in Children With Asthma and Chest Pain. AAP Grand Rounds October 2021; 46 (4): 43. https://doi.org/10.1542/gr.46-4-43 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: asthma, childhood, chest pain, chest x-ray, rales Source: Majerus CR, Tredway TL, Yun NK, et al Utility of chest radiographs in children presenting to a pediatric emergency department with acute asthma exacerbation and chest pain. Pediatr Emerg Care. 2021;37(7):e372-e375; doi:10.1097/PEC.0000000000001615Google Scholar Investigators from Saint Louis University, St Louis, MO, conducted a retrospective study to assess the association between a complaint of chest pain in children with acute asthma presenting to an ED and having a chest radiograph (CXR) obtained during the visit. The researchers also assessed whether chest pain was a predictor of a “positive” CXR. Study participants were children between the ages of 2 and 18 years presenting to the ED of a tertiary care children’s hospital with acute asthma from August 2014 through March 2016 and were identified by review of ICD-9 codes for asthma, pneumothorax, and pneumomediastinum. The medical records of these patients were reviewed, and information on demographics, history of fever (temperature ≥101.0° F), oxygen saturation, breath sounds (eg, “crackles”), presence or absence of chest pain, whether a CXR was obtained and, if so, radiographic findings, provider type, and medications prescribed were abstracted. Patients for whom the presence or absence of chest pain was not noted in the medical record were excluded. When a CXR was obtained, the radiologist’s report was reviewed; the CXR was classified as positive if infiltrates, consolidations, or opacities were noted, if the CXR findings led to a clinical diagnosis of pneumonia and prescription for antibiotics, or if pneumothorax or pneumomediastinum was present. Variables, including chest pain associated with obtaining a CXR and/or a positive CXR on bivariate analyses (P <0.1) were included in multivariate regression models to identify independent predictors of these outcomes. Data were analyzed on 793 children with a mean age of 8.5 years. Overall, 77.7% of study participants were African American, and 60.4% were male. Chest pain was present in 231 children (29.1%), and a CXR was obtained in 184 (23.2%). Positive findings were present on 21 (11.4%) CXRs, including pneumonia (N = 16), pneumomediastinum (3), and pneumothorax (2). Among patients for whom a CXR was obtained, 74 (40%) had chest pain. In the multivariate model, chest pain was associated with an increased chance for having a CXR obtained (OR, 2.2; 95% CI, 1.5, 3.2); other variables statistically associated with an order for CXR included white race, fever, “crackles” on lung examination, oxygen saturation <93%, and provider type. The only variable that was independently associated with a positive CXR was the presence of “crackles” on examination (OR, 4.0; 95% CI, 1.2, 13.0). Chest pain was not statistically associated with a positive CXR (OR, 2.0; 95% CI, 0.7, 5.6). The authors conclude that providers are more likely to obtain a CXR in children with acute asthma who are complaining of chest pain, but that the yield of CXR among these patients is low. Dr Bechtel has disclosed no financial relationship relevant to this commentary. This commentary does not... You do not currently have access to this content." @default.
• W4200593973 created "2021-12-31" @default.
• W4200593973 date "2021-10-01" @default.
• W4200593973 modified "2023-09-26" @default.
• W4200593973 title "Chest Radiograph Utility in Children With Asthma and Chest Pain" @default.
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• W4200593973 doi "https://doi.org/10.1542/gr.46-4-43" @default.
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